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Organization
OAKDALE MALL DENTAL LLP
Active
Organization
OAKDALE MALL DENTAL LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS KRASNOV DDS (OWNER)
(607) 770-8888
Entity
Organization
Contact information
Practice address
601-635 HARRY L DR, 46, JOHNSON CITY, NY 13790-1246
(607) 770-8888
(607) 770-8881
Mailing address
601-635 HARRY L DR, 46, JOHNSON CITY, NY 13790-1246
(607) 770-8888
(607) 770-8881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
046043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01580001
—
NY
Enumeration date
05/25/2012
Last updated
05/25/2012
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