| NPI | 1568611937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALAMON RAFAILOV Dentist 718-730-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 053916) |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2008-09-10 |