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General NPI Number Information
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NPI Number | 1629391370
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Entity Type | Organization
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Legal Business Name | GRABER ORTHODONTICS P.C.
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 2635 NOSTRAND AVE SUITE L2
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City | BROOKLYN
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State | NY
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Zip | 11210-4641
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Country | US
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Telephone | 718-535-7090
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Fax | 718-535-7033
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Provider Business Mailing Address
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Address Line | 2635 NOSTRAND AVE SUITE L2
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City | BROOKLYN
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State | NY
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Zip | 11210-4641
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Country | US
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Telephone | 718-535-7090
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Fax | 718-535-7033
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MORDECHAI GRABER
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Credential | D.D.S.
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Telephone | 718-535-7090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 050751
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License Number State | NY
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