Provider Demographics
NPI:1831496777
Name:LERNER, JAY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:M
Last Name:LERNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 PGA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3829
Mailing Address - Country:US
Mailing Address - Phone:561-627-9000
Mailing Address - Fax:561-627-9162
Practice Address - Street 1:5602 PGA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3829
Practice Address - Country:US
Practice Address - Phone:561-627-9000
Practice Address - Fax:561-627-9162
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist