Provider Demographics
NPI:1386704195
Name:JAY M LERNER DDS AND GERARD J LEMONGELLO JR DMD PTR
Entity type:Organization
Organization Name:JAY M LERNER DDS AND GERARD J LEMONGELLO JR DMD PTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:561-627-9000
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
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
Practice Address - Country:US
Practice Address - Phone:561-627-9000
Practice Address - Fax:561-627-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9266122300000X
FLDN11303122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty