Individual
MR. CHEDDI BRADLAUGH JAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11512 LIBERTY AVE, 2B, SOUTH RICHMOND HILL, NY 11419-1902
(917) 657-3901
Mailing address
11512 LIBERTY AVE, 2B, SOUTH RICHMOND HILL, NY 11419-1902
(917) 657-3901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
033968
NY
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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