| NPI | 1629524897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREY KURUDIMOV President 267-266-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS038323) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |