Individual
JASON Z LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6945 MYRTLE AVE, GLENDALE, NY 11385-7265
(718) 821-4680
Mailing address
155 BORDEN AVE APT 21G, LONG ISLAND CITY, NY 11101-6238
(646) 407-8757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058540
NY
Other
Enumeration date
07/14/2015
Last updated
04/25/2018
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