Individual
JACK JEUN CHEUNG TSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
430 ROBINSON AVE, NEWBURGH, NY 12550
(845) 561-7255
(845) 561-5522
Mailing address
430 ROBINSON AVE, NEWBURGH, NY 12550
(845) 561-7255
(845) 561-5522
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
040109
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
10869
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008043473
—
CT
05
—
00993288
—
NY
Enumeration date
12/06/2006
Last updated
12/21/2013
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