Individual
JACOBO LAVIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
200 SOUTH BROADWAY, SUITE 109, TARRYTOWN, NY 10591-4504
(914) 631-6688
(914) 332-6068
Mailing address
200 SOUTH BROADWAY, SUITE 109, TARRYTOWN, NY 10591-4504
(914) 631-6688
(914) 332-6068
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
035339
NY
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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