Individual
DR. JACOB E ORBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3973 61ST ST, WOODSIDE, NY 11377-3554
(718) 429-5656
Mailing address
15010 71ST AVE, APT. 4C, FLUSHING, NY 11367-2143
(718) 520-8014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
051503
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02567297
—
NY
Enumeration date
11/13/2006
Last updated
07/09/2007
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