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1720238090
ILLYA ALEX TARASENKO
BROOKLYN, NY
NPI
1720238090
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: NY 053958)
Additional Taxonomies
122300000X Dentist
(Licence: PA 037413)
Enumeration Date
2008-09-23
Last Update Date
2008-09-23
Business Address
Dr. ILLYA ALEX TARASENKO DMD
139 KANE ST #4
BROOKLYN, NY 11231-5229
Phone number: 267-304-4701
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Mailing Address
Dr. ILLYA ALEX TARASENKO DMD
139 KANE ST #4
BROOKLYN, NY 11231-5229
Phone number: 267-304-4701
Copy
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