| Jack M. Dorkhom, Dmd, Pllc | |
|
101 Sullys Trl Building 10, Suite 11 Pittsford NY 14534-4552 | |
| (585) 586-8895 | |
| Not Available |
| Full Name | Jack M. Dorkhom, Dmd, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Sullys Trl, Pittsford, New York |
| Authorized Official Name and Position | Jack M Dorkhom (MEMBER/OWNER) |
| Authorized Official Contact | 5855868895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack M. Dorkhom, Dmd, Pllc 101 Sullys Trl Building 10, Suite 11 Pittsford NY 14534-4552 Ph: (585) 586-8895 | Jack M. Dorkhom, Dmd, Pllc 101 Sullys Trl Building 10, Suite 11 Pittsford NY 14534-4552 Ph: (585) 586-8895 |
| NPI Number | 1659721025 |
|---|---|
| Provider Enumeration Date | 06/16/2016 |
| Last Update Date | 06/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659721025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 051194 (New York) | Primary |
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