Organization
ELMHURST ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIEL BALES-KOGAN DMD, MSD, CAGS (ORTHODONTIST)
(617) 319-4180
Entity
Organization
Contact information
Practice address
79-11 41ST AVE, UNIT A107, ELMHURST, NY 11373-1258
(718) 205-2888
Mailing address
79-11 41ST AVE, UNIT A107, ELMHURST, NY 11373-1258
(718) 205-2888
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
055373
NY
Other
Enumeration date
04/25/2013
Last updated
04/25/2013
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