| NPI | 1750074209 |
|---|---|
| Doing Business As | ORTHO ON MAIN |
| Entity Type | Organization |
| Authorized Contact | GARY HEITZLER CEO 914-864-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-05-31 |