Provider Demographics
NPI:1518398106
Name:BRACES OF GREECE
Entity Type:Organization
Organization Name:BRACES OF GREECE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOHAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDSMS
Authorized Official - Phone:585-789-1659
Mailing Address - Street 1:770 FETZNER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1848
Mailing Address - Country:US
Mailing Address - Phone:585-789-1659
Mailing Address - Fax:585-625-0534
Practice Address - Street 1:770 FETZNER RD.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626
Practice Address - Country:US
Practice Address - Phone:585-789-1659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056408302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization