| NPI | 1295990422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL ISAKHAROV Sole Proprietor 718-897-9745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 049803) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2008-07-28 |