| NPI | 1003087008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRYEM KANDINOV Owner 718-261-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 045011) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |