Organization
EMPIRE DENTAL, P.C.
Active
Other names
Jayson Lo, D.M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYSON C. LO DMD (PRESIDENT)
(917) 498-7152
Entity
Organization
Contact information
Practice address
13347 SANFORD AVE, #C1B, FLUSHING, NY 11355-5800
(718) 888-8828
(718) 888-8827
Mailing address
11201 QUEENS BLVD, 18J, FOREST HILLS, NY 11375-5566
(718) 575-1653
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
049413
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02427067
—
NY
01
—
9175708
DORAL
NY
Enumeration date
04/25/2007
Last updated
01/29/2008
Update your record
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