| NPI | 1043580038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAVEL KRASTEV Owner/President 516-355-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 044978) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |