Organization
DR. I DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUIL ILYAYEV DDS (DENTIST)
(631) 517-8166
Entity
Organization
Contact information
Practice address
8610 GRAND AVE, 1B, ELMHURST, NY 11373
(631) 517-8166
(631) 517-8166
Mailing address
8610 GRAND AVE, 1B, ELMHURST, NY 11373
(631) 517-8166
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
058141
NY
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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