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General NPI Number Information
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NPI Number | 1174782817
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Entity Type | Organization
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Legal Business Name | COLUMBIA ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 13620 38TH AVE STE 5B
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City | FLUSHING
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State | NY
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Zip | 11354-4233
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Country | US
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Telephone | 718-661-1186
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Fax | 718-661-1189
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Provider Business Mailing Address
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Address Line | 13620 38TH AVE STE 5B
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City | FLUSHING
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State | NY
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Zip | 11354-4233
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Country | US
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Telephone | 718-661-1186
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Fax | 718-661-1189
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK LU
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Credential | DDS, MS
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Telephone | 718-661-1186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 048524
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License Number State | NY
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