| NPI | 1497436760 |
|---|---|
| Doing Business As | EASTSIDE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | ERICA QUINTEROS Credentialing Manager 212-879-3956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-08-01 |