| NPI | 1952814998 |
|---|---|
| Doing Business As | STATE FAMILY DENTAL CARE PC |
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN KISELEV Owner 718-554-4299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-11-13 |