PA Orthodontics, Ppllc
Dentist, Orthodontics and Dentofacial Orthopedics in Dresher, PA. Organization (NPI-2).
NPI number1558084129
StatusActive
Last updated in NPPESSep 20, 2022
Details
- NPI
- 1558084129
- Entity type
- Organization (NPI-2)
- Legal business name
- PA Orthodontics, Ppllc
- Organization subpart
- No
- Enumeration date
- Sep 20, 2022
- Certification date
- Sep 20, 2022
- Last updated
- Sep 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
Other names
- Diamond Braces (Doing Business As)
Practice location
227 Dryden Rd EDresher, PA 19025-1015
Phone 267-607-3050 · Fax 888-292-7017
Mailing address
15 Engle St Ste 204Englewood, NJ 07631-2920
Phone 201-308-8181
Authorized official
Oleg Drut
Owner
2013088181
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