NPI | 1619405412 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXANDER VOLCHONOK Owner 929-293-0200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NY 50058006) |
Enumeration Date | 2017-05-24 |
Last Update Date | 2022-07-21 |