| NPI | 1366880841 |
|---|---|
| Doing Business As | 3RD AVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | EDWARD SHALOMOV President 718-290-7934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 054092) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 047852) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |