Organization
HOLLYWOOD ORTHODONTICS PC-
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER EVAN FEIBISH DMD,MS (OWNER)
(718) 595-0050
Entity
Organization
Contact information
Practice address
9438 60TH AVE, ELMHURST, NY 11373-5070
(718) 595-0050
Mailing address
9438 60TH AVE, ELMHURST, NY 11373-5070
(718) 595-0050
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02958643
—
NY
Enumeration date
12/16/2013
Last updated
12/16/2013
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