Individual
DR. JASON LIEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2102 BAY RIDGE PKWY, BROOKLYN, NY 11204-5945
(718) 259-3828
Mailing address
2102 BAY RIDGE PKWY, BROOKLYN, NY 11204-5945
(718) 259-3828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049885
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02439247
—
NY
01
—
9178159
DORAL
NY
Enumeration date
12/28/2006
Last updated
05/21/2012
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