Individual
JACQUELINE H SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2812 LONG BEACH RD, OCEANSIDE, NY 11572-2229
(516) 536-5340
(516) 536-5383
Mailing address
2812 LONG BEACH RD, OCEANSIDE, NY 11572-2229
(516) 536-5340
(516) 536-5383
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
044911
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02615016
—
NY
Enumeration date
10/18/2007
Last updated
10/18/2007
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