Individual
JACK KERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11 CRICKETT LN, 11 CRICKET LANE, GREAT NECK, NY 11024-1004
(516) 466-5868
Mailing address
11 CRICKETT LN, KINGS POINT, NY 11024-1004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21510
NY
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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