| NPI | 1457405862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY VOLOTSENKO President 718-495-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 047879) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |