| NPI | 1427220342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PEYSAKHOV Director 718-375-1827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 049224-1) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |