Organization
BRACES @ MIDDLETOWN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE DIERNA DDS (PRESIDENT)
(732) 671-6621
Entity
Organization
Contact information
Practice address
2 APPLE FARM RD, RED BANK, NJ 07701-5091
(732) 671-6621
(732) 671-2166
Mailing address
2 APPLE FARM RD, RED BANK, NJ 07701-5094
(732) 671-6621
(732) 671-2166
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI00812500
NJ
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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