| NPI | 1023155470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS KRASNOV Owner 914-997-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 046043) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 052674) |
| 1223G0001X Dentist, General Practice (Licence: NY 052119) | |
| 1223G0001X Dentist, General Practice (Licence: NY 050148) | |
| 1223G0001X Dentist, General Practice (Licence: NY 052112) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 048760) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 042707) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 048185) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |