LARISA ILYUTOVICH

FORT LEE, NJ
NPI1780033225
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: NJ  DI020299)
Enumeration Date2016-06-06
Last Update Date2016-06-06
Business Address
-- LARISA ILYUTOVICH
301 BRIDGE PLZ N SUITE 2
FORT LEE, NJ 07024-5059
Phone number: 201-346-4660
Mailing Address
-- LARISA ILYUTOVICH
301 BRIDGE PLZ N SUITE 2
FORT LEE, NJ 07024-5059
Phone number: 201-346-4660
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