Jaime M Poulos D.D.S.

NPI 1619138229 - Dentist - 1223G0001X

NPI Details
NPI 1619138229
Gender Male
Enumeration Date 06/17/2008
Last Updated 10/06/2009
Entity Type Individual
Active Over 8 years ago
Practice Location
22 LAUREL AVE
NORTHPORT NY, 11768-3165, US
Phone (631) 262-0644
Fax
Business Location
6 DITMAR LN
EAST NORTHPORT NY, 11731-5220, US
Phone (516) 729-6799
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019026797
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According to our database, Dr. Jaime M Poulos D.D.S. NPI is 1619138229, taxonomy code is 1223G0001X and license number is 019026797, license state is located at Illinois. Jaime M Poulos D.D.S. physically located at 22 Laurel Ave, Northport NY, 11768-3165. NPI Number Jaime M Poulos D.D.S. has the Individual type.

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1619138229 NPI number is provided on an as is basis without warranty of any kind. 1619138229 is maintained by the National Plan & Provider Enumeration System. The contents of Jaime M Poulos D.D.S. are for informational purposes only.