| NPI | 1104093814 |
|---|---|
| Former Legal Business Name | IK DENTAL |
| Entity Type | Organization |
| Authorized Contact | IGOR KLEBANOV Autherized Official 212-568-1500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 045540) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 045540) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2022-07-21 |