Individual
MR. ARIEL BALES-KOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
79-11 41ST AVE, UNIT A107, ELMHURST, NY 11373
(718) 205-2888
(718) 205-2855
Mailing address
305 W 150TH ST, APT 701, NEW YORK, NY 10039-2225
(617) 319-4180
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
055373
NY
Other
Enumeration date
09/26/2007
Last updated
04/25/2013
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