| NPI | 1487797338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIYA GUBENKO Executive Officer 718-615-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 046347) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-15 |