| NPI | 1114332798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTASIA KOVALEVA Office Manager 718-618-7564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 056676) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |