Organization
LASER DENTISTRY FOR CHILDREN LLC
Active
Other names
Pediatric Dentistry of Flushing
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY L JACOBSON DMD (OWNER)
(845) 369-3703
Entity
Organization
Contact information
Practice address
13514 JEWEL AVE, FLUSHING, NY 11367-1920
(718) 997-6453
Mailing address
13514 JEWEL AVE, FLUSHING, NY 11367-1920
(718) 997-6453
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
045485
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/31/2006
Last updated
07/12/2023
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