Individual
DR. JESSICA LOO MARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
128 MOTT ST, SUITE 203, NEW YORK, NY 10013-5540
(212) 965-8113
Mailing address
128 MOTT ST, SUITE 203, NEW YORK, NY 10013-5540
(212) 965-8113
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
049750-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016614
DORAL DENTAL
NY
05
—
02289563
—
NY
Enumeration date
08/31/2006
Last updated
07/08/2007
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