NPI | 1316287717 |
---|---|
Entity Type | Organization |
Authorized Contact | ROSTISLAV KRASNOV Owner 917-902-9515 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN16377) |
Enumeration Date | 2013-02-21 |
Last Update Date | 2013-02-21 |