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General NPI Number Information
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NPI Number | 1518141696
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Entity Type | Organization
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Legal Business Name | JACOB E. ORBACH DDS, P.C.
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 15020 71ST AVE APT. 3C
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City | FLUSHING
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State | NY
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Zip | 11367-2147
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Country | US
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Telephone | 718-551-4037
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Fax |
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Provider Business Mailing Address
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Address Line | 15020 71ST AVE APT. 3C
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City | FLUSHING
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State | NY
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Zip | 11367-2147
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Country | US
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Telephone | 718-551-4037
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACOB E. ORBACH
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Credential | DDS
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Telephone | 718-551-4037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 051503
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License Number State | NY
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