Organization
JACOB A. AVNER, DDS PC
Active
Other names
Great Smiles of NY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB AVNER DDS (DENTIST/OWNER)
(718) 275-7300
Entity
Organization
Contact information
Practice address
9725 64TH AVE, UNIT: G-3, REGO PARK, NY 11374-2236
(718) 275-7300
(718) 275-7307
Mailing address
9725 64TH AVE, UNIT: G-3, REGO PARK, NY 11374-2236
(718) 275-7300
(718) 275-7307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0496891
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02282222
—
NY
Enumeration date
10/07/2015
Last updated
10/07/2015
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