| NPI | 1639311319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR IZRAILOV Dentist/Owner 718-294-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050642) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |