| NPI | 1063809572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMANUEL ABAYEV President 347-456-1839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 056590-1) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |