Organization
BERGENLINE ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG DRUT (DDS)
(201) 662-0662
Entity
Organization
Contact information
Practice address
5918 BERGENLINE AVE, SUITE 201 B, WEST NEW YORK, NJ 07093-1392
(201) 662-0662
Mailing address
5918 BERGENLINE AVE, SUITE 201 B, WEST NEW YORK, NJ 07093-1392
(201) 662-0662
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DI20707
NJ
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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