| NPI | 1508535659 |
|---|---|
| Doing Business As | NY DENTAL BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | KIMIA KOHANBASH Owner 718-909-7163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-09-12 |
| Last Update Date | 2021-09-12 |