| NPI | 1669535217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN V KATAYEV Owner 718-379-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 0477111) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2013-02-12 |