| NPI | 1548771967 |
|---|---|
| Former Name | LEONID SVERDLOV |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02693300) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN22203) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-06-07 |