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Organization

CONCERNED DENTAL CARE OF PORT JEFFERSON, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY FENSTERSTOCK DDS (PRESIDENT)
(631) 928-1018
Entity
Organization

Contact information

Practice address
492 OLD TOWN ROAD, PORT JEFFERSON STATION, NY 11776
(631) 928-1018
Mailing address
492 OLD TOWN ROAD, PORT JEFFERSON STATION, NY 11776
(631) 928-1018

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
032077
NY

Other

Enumeration date
06/12/2012
Last updated
06/12/2012
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