| NPI | 1700566734 |
|---|---|
| Doing Business As | OVERLAKE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JADGEV HEIR CEO/President 518-441-5483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |