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1780033225
LARISA ILYUTOVICH
FORT LEE, NJ
NPI
1780033225
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: NJ DI020299)
Enumeration Date
2016-06-06
Last Update Date
2016-06-06
Business Address
LARISA ILYUTOVICH
301 BRIDGE PLZ N SUITE 2
FORT LEE, NJ 07024-5059
Phone number: 201-346-4660
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Mailing Address
LARISA ILYUTOVICH
301 BRIDGE PLZ N SUITE 2
FORT LEE, NJ 07024-5059
Phone number: 201-346-4660
Copy
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