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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
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