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Individual

JAKE FRIED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
92 SWEET RD, BALLSTON LAKE, NY 12019-1804
(914) 419-4100
Mailing address
92 SWEET RD, BALLSTON LAKE, NY 12019-1804
(914) 419-4100

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
057555
NY

Other

Enumeration date
01/07/2014
Last updated
05/07/2020
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