Individual
JACK M LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
375 ORANGE ST, NEW HAVEN, CT 06511-6406
(203) 624-7571
(203) 624-2675
Mailing address
375 ORANGE ST, NEW HAVEN, CT 06511-6406
(203) 624-7571
(203) 624-2675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4665
CT
Other
Enumeration date
02/13/2007
Last updated
11/14/2016
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