| NPI | 1952765828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDOUARD ETLIS President 646-512-2777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 047627) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2016-04-07 |