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Organization
US DENTAL CHOICE P.L.L.C
Active
Organization
US DENTAL CHOICE P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR IZRAILOV (DENTIST/OWNER)
(718) 294-8800
Entity
Organization
Contact information
Practice address
1963 GRAND CONCOURSE, LOWER LEVEL, BRONX, NY 10453-4994
(718) 294-8800
(718) 731-5100
Mailing address
1963 GRAND CONCOURSE, LOWER LEVEL, BRONX, NY 10453-4994
(718) 294-8800
(718) 731-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050642
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050642
LICENSE
NY
Enumeration date
03/27/2009
Last updated
03/27/2009
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