Organization
CHURCH AVE ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLEG DRUT DDS (OWNER)
(718) 282-8222
Entity
Organization
Contact information
Practice address
2848 CHURCH AVE, 2ND FLOOR, BROOKLYN, NY 11226-4106
(718) 282-8222
(718) 282-8244
Mailing address
2848 CHURCH AVE, 2ND FLOOR, BROOKLYN, NY 11226-4106
(718) 282-8222
(718) 282-8244
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DI20707
NJ
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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