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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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