Organization
HOUSE OF BRACES QUEENS ORTHODONTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LIN (RECEPTIONIST)
(212) 267-1800
Entity
Organization
Contact information
Practice address
4235 MAIN ST STE 3F, FLUSHING, NY 11355-3956
(718) 888-7781
Mailing address
4235 MAIN ST STE 3F, FLUSHING, NY 11355-3956
(718) 888-7781
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
42324
NY
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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