| NPI | 1760862775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTON MOSKALENCO Owner 718-462-7436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053035) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |