NPI | 1720516685 |
---|---|
Former Name | OKSANA VALENTINOVNA FURSOV |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 1001784-15) |
Enumeration Date | 2017-05-23 |
Last Update Date | 2025-07-02 |