Provider Demographics
NPI:1225155260
Name:DR. EPSTEIN, ELKIN SARGISS ORTHODONTICS, PA
Entity Type:Organization
Organization Name:DR. EPSTEIN, ELKIN SARGISS ORTHODONTICS, PA
Other - Org Name:BRACE PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:ELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-448-6600
Mailing Address - Street 1:234 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1402
Mailing Address - Country:US
Mailing Address - Phone:609-448-6600
Mailing Address - Fax:609-426-9192
Practice Address - Street 1:234 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1402
Practice Address - Country:US
Practice Address - Phone:609-448-6600
Practice Address - Fax:609-426-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ216031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty