| NPI | 1306931514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VITALIY FABRIKANT President 212-740-7568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 048425) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |