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Organization
NY MODERN DENTISTRY, P.C.
Active
Organization
NY MODERN DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRY MALAYEV D.D.S. (PRESIDENT)
(212) 764-2229
Entity
Organization
Contact information
Practice address
340 MADISON AVE, SUITE 4C, NEW YORK, NY 10173-0002
(212) 764-2229
Mailing address
6416 ASQUITH CRES, REGO PARK, NY 11374-5016
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057457
NY
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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