Organization
ORTHODONTICS AT JACKSON HEIGHTS SMILES, PLLC
Active
Organization
ORTHODONTICS AT JACKSON HEIGHTS SMILES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAJU MATHEW D.D.S. (OWNER)
(631) 235-9007
Entity
Organization
Contact information
Practice address
3062 79TH ST, 2ND FLOOR, EAST ELMHURST, NY 11370-1510
(718) 426-9400
(718) 426-9497
Mailing address
210 W 70TH ST, APT 1101, NEW YORK, NY 10023-4304
(631) 235-9007
(212) 954-5583
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
050711
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03128301
—
NY
Enumeration date
04/10/2014
Last updated
05/29/2014
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