Organization
EZZYBRACES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMEN DHYLLON (MEMBER)
(610) 876-3300
Entity
Organization
Contact information
Practice address
130 E BROOKHAVEN RD, BROOKHAVEN, PA 19015-2310
(610) 876-3300
(610) 876-2042
Mailing address
130 E BROOKHAVEN RD, BROOKHAVEN, PA 19015-2310
(610) 876-3300
(610) 876-2042
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS038245
PA
Other
Enumeration date
01/30/2015
Last updated
01/31/2015
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