Organization
DIAMOND BRACES OF HACKENSACK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG DRUT (OWNER)
(201) 308-8181
Entity
Organization
Contact information
Practice address
17 SUMMIT AVE, HACKENSACK, NJ 07601-1218
(201) 996-0770
(201) 875-5588
Mailing address
15 ENGLE ST, SUITE 303, ENGLEWOOD, NJ 07631-2936
(201) 996-0770
(201) 875-5588
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
02070700
NJ
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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