| NPI | 1427021708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR KHAYKIW Vice President 718-792-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 046604) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 046633) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |