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Individual

MR. JERROLD F HELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
425 GRAND STREET, NEW YORK, NY 10002
(212) 674-2258
(212) 677-2979
Mailing address
425 GRAND STREET, NEW YORK, NY 10002
(212) 674-2258
(212) 677-2979

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0027246
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00282531
NY
Enumeration date
11/13/2006
Last updated
07/08/2007
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