| NPI | 1437372380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAVEL NIDERMAN President 212-996-5996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 044976) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 044976) |
| 1223P0300X Dentist, Periodontics (Licence: NY 048519) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-07-20 |