Organization
HARLEM DENTAL COSMETIC PLAZA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI JOHN JAZAYERI D.D.S. (PRESIDENT)
(212) 348-1177
Entity
Organization
Contact information
Practice address
1916 3RD AVE GRD FL, NEW YORK, NY 10029
(212) 348-1177
Mailing address
1916 3RD AVE GRD FL, NEW YORK, NY 10029
(212) 348-1177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053328
NY
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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