| NPI | 1144428384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER MIKHAILOV Owner 718-861-8060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 041796) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-08-22 |