Organization
WILLISTON ORTHODONTIC PC
Active
Other names
Williston Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
51 CHARLES ST, MINEOLA, NY 11501-1941
(516) 746-3204
Mailing address
51 CHARLES ST, MINEOLA, NY 11501-1941
(516) 746-3204
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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