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 |