| NPI | 1396281135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIYA ETKINA Dentist/Owner 718-937-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY C50603) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 057328) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |