Diamond Braces Wayne | |
401 Hamburg Tpke Suite 210 Wayne NJ 07470-2154 | |
(973) 200-8380 | |
(973) 200-8385 |
Full Name | Diamond Braces Wayne |
---|---|
Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 401 Hamburg Tpke, Wayne, New Jersey |
Authorized Official Name and Position | Oleg Drut (DOCTOR) |
Authorized Official Contact | 9732008380 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Diamond Braces Wayne 15 Engle St Suite #303 Englewood NJ 07631-2936 Ph: (201) 308-8181 | Diamond Braces Wayne 401 Hamburg Tpke Suite 210 Wayne NJ 07470-2154 Ph: (973) 200-8380 |
NPI Number | 1174934251 |
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Provider Enumeration Date | 05/12/2014 |
Last Update Date | 05/12/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174934251 | NPI | - | NPPES |
8072701 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 22DI2070700 (New Jersey) | Primary |
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