| NPI | 1932866514 |
|---|---|
| Doing Business As | PREMIER DENTAL |
| Entity Type | Organization |
| Authorized Contact | YAKOV FUZAYLOV Owner 718-470-2320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |