Provider Demographics
NPI:1497087639
Name:DOSCHER, JESSE C (DDS, MSC)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:C
Last Name:DOSCHER
Suffix:
Gender:M
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 CENTRAL PARK AVENUE, SUITE 207
Mailing Address - Street 2:SCARSDALE ORAL SURGERY, P.C.
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-472-5252
Mailing Address - Fax:914-722-5987
Practice Address - Street 1:1075 CENTRAL PARK AVENUE, SUITE 207
Practice Address - Street 2:SCARSDALE ORAL SURGERY, P.C.
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-472-5252
Practice Address - Fax:914-722-5987
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532821223P0106X, 1223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program