| NPI | 1720338312 |
|---|---|
| Doing Business As | VISTA DENTAL |
| Entity Type | Organization |
| Authorized Contact | DANIIL LIBOV Dentist Member/Manager 646-932-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 055892) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2012-09-11 |