Organization
SPARKIL DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FANNY SHAULOV VAINER DMD (DENTIST)
(347) 873-3083
Entity
Organization
Contact information
Practice address
609 MAIN ST, SPARKILL, NY 10976-1209
(845) 359-0288
Mailing address
109 TRUMAN DR, CRESSKILL, NJ 07626-1709
(347) 873-3083
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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