Organization
AUSTIN 26 DENTAL GROUP PLLC
Active
Other names
Austin Street Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA A PITKOUVICH (MANAGER)
(917) 391-8000
Entity
Organization
Contact information
Practice address
7017 AUSTIN ST, 3RD FLOOR, FOREST HILLS, NY 11375-4875
(718) 261-4000
(718) 228-8886
Mailing address
7017 AUSTIN ST, 3RD FLOOR, FOREST HILLS, NY 11375-4875
(718) 261-4000
(718) 228-8886
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
054245
NY
Other
Enumeration date
07/17/2014
Last updated
07/20/2014
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