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General NPI Number Information
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NPI Number | 1891123923
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Entity Type | Organization
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Legal Business Name | PAPASIKOS ORTHODONTICS
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 11/10/2013
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Provider Practice Location Address
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Address Line | 55 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3439
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Country | US
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Telephone | 973-744-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 55 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3439
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Country | US
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Telephone | 973-744-2511
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ARIANNA PAPASIKOS
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Credential | DMD, MBA
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Telephone | 908-246-4962
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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 | 22DI02403700
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License Number State | NJ
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