| NPI | 1427280452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA BOGOMOLOVA President 718-332-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052096) |
| Enumeration Date | 2009-08-09 |
| Last Update Date | 2009-08-09 |