Individual
ISRAEL SHIMUNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9815 65TH RD APT 1B, REGO PARK, NY 11374-3505
(347) 247-6810
Mailing address
6259 108TH ST APT 5H, FOREST HILLS, NY 11375-1314
(347) 247-6810
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
06136301
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/12/2019
Last updated
06/10/2021
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