Organization
EAST SIDE PEDIATRIC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA LOO MARN DDS (PEDIATRIC DENTIST/PRESIDENT)
(212) 965-8113
Entity
Organization
Contact information
Practice address
133 EAST 58TH STREET, SUITE 402, NEW YORK, NY 10022-1157
(212) 965-8113
(212) 965-8114
Mailing address
128 MOTT STREET, SUITE 403, NEW YORK, NY 10013-5575
(212) 965-8113
(212) 965-8114
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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