| NPI | 1164575478 |
|---|---|
| Former Legal Business Name | ORTHOCLUB PC |
| Entity Type | Organization |
| Authorized Contact | OLEG DRUT Owner 201-308-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DI20707) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-31 |