Individual
DR. JAIME M POULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
120 NEW YORK AVE STE 2W, HUNTINGTON, NY 11743-2743
(631) 673-3755
(631) 673-3433
Mailing address
6 DITMAR LN, EAST NORTHPORT, NY 11731-5220
(516) 729-6799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019026797
IL
1223G0001X
General Practice Dentistry
Primary
052074
NY
Other
Enumeration date
06/17/2008
Last updated
04/09/2024
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