Organization
JERICHO ORTHODONTICS AND PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHOI DDS (PRESIDENT)
(917) 657-3934
Entity
Organization
Contact information
Practice address
325 N BROADWAY, JERICHO, NY 11753-2015
(917) 657-3934
Mailing address
14 SHERWOOD LN, ROSLYN HEIGHTS, NY 11577-2511
(917) 657-3934
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
054937
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
9574651
NY
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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