Organization
DIAMOND BRACES OF NORWALK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG DRUT DDS (OWNER)
(201) 308-8181
Entity
Organization
Contact information
Practice address
15 ENGLE ST, SUITE 303, ENGLEWOOD, NJ 07631-2936
(201) 308-8181
Mailing address
380 SUNRISE MALL, MASSAPEQUA, NY 11758-4325
(201) 308-8181
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
047218-1
NJ
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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