| NPI | 1124291760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY VOLOTSENKO Owner 718-872-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 047879) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |