| NPI | 1548685357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURI RESHETNIKOV Owner 718-205-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050616) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2023-03-07 |