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Organization
VISTA DENTAL, PLLC
Active
Organization
VISTA DENTAL, PLLC
Active
Other names
Vista Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIIL LIBOV DMD (DENTIST MEMBER/MANAGER)
(646) 932-1185
Entity
Organization
Contact information
Practice address
2951 OCEAN AVE, SUITE BB, BROOKLYN, NY 11235-3275
(646) 932-1185
Mailing address
2951 OCEAN AVE, SUITE BB, BROOKLYN, NY 11235-3275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
055892
NY
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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