| NPI | 1881197689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA ZAVULUNOVA Owner/President 718-459-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NY 01778936) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2018-03-18 |