| NPI | 1932326618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS KRASNOV Office Administrator 845-692-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 049213) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 052828) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 048760) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 042707) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |