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Organization
ST LAWRENCE DENTAL STUDIO PLLC
Active
Organization
ST LAWRENCE DENTAL STUDIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSANDR MEDVED DDS (OPERATING MANAGER)
(315) 379-9195
Entity
Organization
Contact information
Practice address
14 MINER ST, CANTON, NY 13617-1286
(315) 379-9195
Mailing address
119 MINER RD, MALONE, NY 12953-6103
(518) 483-8157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052242
NY
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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