| NPI | 1194862953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY VOLOTSENKO CEO 718-442-9254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 047879) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 0419971) |
| 1223G0001X Dentist, General Practice (Licence: NY 050410) | |
| 1223G0001X Dentist, General Practice (Licence: NY 051388) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |