Organization
PRIMARY TEETH PEDIATRIC DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE FRIED DDS (OWNER)
(518) 601-2220
Entity
Organization
Contact information
Practice address
199 S MAIN ST, GLOVERSVILLE, NY 12078-4240
(518) 601-2220
(518) 601-2221
Mailing address
199 S MAIN ST, GLOVERSVILLE, NY 12078-4240
(518) 601-2220
(518) 601-2221
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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