| NPI | 1770143364 |
|---|---|
| Former Legal Business Name | FAMILY DENTAL PC |
| Entity Type | Organization |
| Authorized Contact | RUDOLF DDS AKILOV Dentist 212-304-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |