Organization
DEEPA JAYAM, DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPA JAYAM DMD (PRESIDENT)
(516) 884-1654
Entity
Organization
Contact information
Practice address
3709 JUNCTION BLVD, CORONA, NY 11368-1740
(516) 884-1654
Mailing address
3 PARKWAY DR, ROSLYN HEIGHTS, NY 11577-2705
(516) 656-0881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053694
NY
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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