| NPI | 1750828083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG DRUT Owner 718-383-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 047218) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |