Individual
DR. ILYA YAGUDAYEV
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6511 108TH ST, OFFICE A, FOREST HILLS, NY 11375-1854
(718) 997-1954
Mailing address
18 KEW GARDENS RD, KEW GARDENS, NY 11415-1104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046209
NY
Other
Enumeration date
10/24/2005
Last updated
07/08/2007
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