| NPI | 1275771248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA PONOMAREVA Owner 718-329-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 049663) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-01-29 |