Individual
SERGEI A KUZNETSOV
Active
Individual
SERGEI A KUZNETSOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6538
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
061202
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083031553
DENTAL
NY
Enumeration date
03/23/2014
Last updated
09/25/2023
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