Individual
DAVID JIAYUAN XU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2521 VESTAL PKWY W, VESTAL, NY 13850
(607) 754-2217
Mailing address
2066 E 26TH ST, BROOKLYN, NY 11229-2442
(917) 724-4172
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059877-1
NY
Other
Enumeration date
02/18/2017
Last updated
09/19/2018
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