| NPI | 1558555458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VADIM LEYBOVICH President 718-435-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 050057) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |