Organization
CARLE PLACE DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI JOHN JAZAYERI D.D.S. (PRESIDENT)
(917) 528-1092
Entity
Organization
Contact information
Practice address
407 E JERICHO TPKE, CARLE PLACE, NY 11514-1027
(516) 747-8150
(516) 747-8152
Mailing address
407 E JERICHO TPKE, CARLE PLACE, NY 11514-1027
(516) 747-8150
(516) 747-8152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053328
NY
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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