Individual
DR. JARED SCOTT PERCYZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10 HUNTER AVE, MILLER PLACE, NY 11764-2714
(631) 821-3838
(631) 821-8022
Mailing address
10 HUNTER AVE, MILLER PLACE, NY 11764-2714
(631) 821-3838
(631) 821-8022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
009801
CT
1223G0001X
General Practice Dentistry
054020-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054020-1
NY STATE LICENSE
NY
Enumeration date
03/14/2009
Last updated
03/14/2009
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