Organization
PEDIATRIC DENTISTRY OF MONSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY JACOBSON DMD (OWNER)
(845) 369-0600
Entity
Organization
Contact information
Practice address
29 N AIRMONT RD, SUFFERN, NY 10901-4242
(845) 369-0600
(845) 369-0800
Mailing address
29 N AIRMONT RD STE 21, SUFFERN, NY 10901-4242
(845) 369-0600
(845) 369-0800
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
10/01/2013
Last updated
07/12/2023
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