Organization
JORDAN LISSAUER ORTHODONTICS PC
Active
Organization
JORDAN LISSAUER ORTHODONTICS PC
Active
Other names
103 Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN LISSAUER DMD (PRESIDENT)
(718) 966-2720
Entity
Organization
Contact information
Practice address
3767 HYLAN BLVD, STATEN ISLAND, NY 10308-3505
(718) 966-2720
Mailing address
3767 HYLAN BLVD, STATEN ISLAND, NY 10308-3518
(718) 966-2720
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/29/2019
Last updated
08/03/2026
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