Organization
AVENUE U ORTHODONTICS, PLLC
Active
Other names
Orthoclub PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLEG DRUT DDS (OWNER)
(201) 308-8181
Entity
Organization
Contact information
Practice address
79 AVENUE U, BROOKLYN, NY 11223-3554
(718) 373-6707
(888) 292-7017
Mailing address
15 ENGLE STREET, SUITE 204, ENGLEWOOD, NJ 07631-2936
(201) 308-8181
(888) 292-7017
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DI20707
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045063
—
NJ
05
—
03128943
—
NY
Enumeration date
01/19/2007
Last updated
08/31/2020
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