Individual
DR. JAKE DORFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3076 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-2210
(610) 865-2777
Mailing address
3076 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-2210
(610) 865-2777
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS040396
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS040396
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356591903
SPARK ORTHODONTICS, P.C.
PA
Enumeration date
05/16/2017
Last updated
10/16/2017
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