| NPI | 1295275220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN KATAYEV President 718-740-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |