ILLYA ALEX TARASENKO

BROOKLYN, NY
NPI1720238090
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: NY  053958)
Additional Taxonomies122300000X Dentist
(Licence: PA  037413)
Enumeration Date2008-09-23
Last Update Date2008-09-23
Business Address
Dr. ILLYA ALEX TARASENKO DMD
139 KANE ST #4
BROOKLYN, NY 11231-5229
Phone number: 267-304-4701
Mailing Address
Dr. ILLYA ALEX TARASENKO DMD
139 KANE ST #4
BROOKLYN, NY 11231-5229
Phone number: 267-304-4701