| NPI | 1265658488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIYA I SAFONOVA President 718-376-1090 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 046621) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 046621) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2010-08-26 |