| NPI | 1861523771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGUEI KOPETSKOV President 646-827-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 049097) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |