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Individual

DR. JASON TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MD

Contact information

Practice address
437 W 125TH ST, NEW YORK, NY 10027-4201
(646) 827-9819
Mailing address
22 N 6TH ST APT 4P, BROOKLYN, NY 11249-3077

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
057483
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
057483
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
306840
NY

Other

Enumeration date
07/02/2013
Last updated
08/14/2022
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