Individual
DR. JONAH PETER SPAETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3237 NY-112, BLDG 6 SUITE 7B, MEDFORD, NY 11763
(631) 320-0880
Mailing address
3237 NY-112, BLDG 6 SUITE 7B, MEDFORD, NY 11763
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
063505
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2021
Last updated
09/18/2023
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