Individual
DR. JACK MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
305 E 55TH ST, SUITE 201, NEW YORK, NY 10022-4148
(212) 755-3355
(212) 935-6964
Mailing address
305 E 55TH ST, SUITE 201, NEW YORK, NY 10022-4148
(212) 755-3355
(212) 935-6964
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
29553
NY
Other
Enumeration date
04/21/2010
Last updated
04/21/2010
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