Provider Demographics
NPI:1346934270
Name:BEN-JACOB, AHRON
Entity Type:Individual
Prefix:DR
First Name:AHRON
Middle Name:
Last Name:BEN-JACOB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 KEARSING PKWY APT B
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-7235
Mailing Address - Country:US
Mailing Address - Phone:845-270-0963
Mailing Address - Fax:
Practice Address - Street 1:341 E YAMATO RD STE A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4915
Practice Address - Country:US
Practice Address - Phone:561-962-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN28016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist