NPI | 1407279177 |
---|---|
Former Legal Business Name | ALEXANDER O. ANTIPOV, D.D.S., INC |
Entity Type | Organization |
Authorized Contact | YELENA MYALIK Office Manager 916-783-2110 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2014-01-30 |
Last Update Date | 2014-01-30 |