| NPI | 1003100124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERY DUBOVIKOV Dds 718-948-0870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 0389861) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |