| NPI | 1295956357 |
|---|---|
| Professional Name | GENNADY M FUNDAMINSKY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 26062) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-01-28 |