# BUSHWICK ORTHODONTIC STUDIO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679310882
- **Authorized official:** ANDRES GONZALEZ DMD (PRESIDENT)
- **Authorized official phone:** (347) 382-6861

## Contact information

- **Practice address:** 203 IRVING AVE FL 1, BROOKLYN, NY 11237-8077
- **Practice address phone:** (347) 382-6861
- **Mailing address:** 23 N HENRY ST APT 1, BROOKLYN, NY 11222-5055
- **Mailing address phone:** (305) 450-8116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/15/2024
- **Last updated:** 07/15/2024