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Organization

EMPIRE STATE ORTHODONTICS, PC

Active
Parent organization
EMPIRE STATE ORTHODONTICS, PC
Other names
Scotia Orthodontics
Organization subpart
Yes

Provider details

NPI number
Legal business name
EMPIRE STATE ORTHODONTICS, PC
Authorized official
CASEY LONABOCKER (VP STRATEGY AND OPERATIONS)
(617) 535-3364
Entity
Organization

Contact information

Practice address
207 MOHAWK AVE # 1A, SCOTIA, NY 12302-2150
(518) 535-3294
Mailing address
131 DARTMOUTH ST FL 3, BOSTON, MA 02116-5297

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
11/02/2021
Last updated
11/20/2024
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