| NPI | 1336498070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IOSIF UVAYDOV Owner 718-575-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 044283) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2012-09-07 |