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1811046741
EZRO FATTAKHOV
FOREST HILLS, NY
NPI
1811046741
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NY 046846)
Enumeration Date
2007-01-09
Last Update Date
2007-07-08
Business Address
Dr. EZRO FATTAKHOV DDS
10510 62ND RD APT 1F
FOREST HILLS, NY 11375-1137
Phone number: 718-760-8400
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Mailing Address
Dr. EZRO FATTAKHOV DDS
9926 64TH RD
REGO PARK, NY 11374-2646
Phone number: 718-830-9091
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