| NPI | 1598200594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA LASKINA Credentialing 267-335-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA 721975) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |