| NPI | 1417135211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA ZAVULUNOVA Owner 718-459-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 047357) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 047357) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-02-04 |