Organization
IK DENTAL
Active
Parent organization
YES
Other names
ik dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
YES
Authorized official
DR. IGOR KLEBANOV DDS (AUTHERIZED OFFICIAL)
(212) 568-1500
Entity
Organization
Contact information
Practice address
4405 BROADWAY, NEW YORK, NY 10040-4014
(212) 568-1500
(855) 201-3647
Mailing address
4405 BROADWAY, NEW YORK, NY 10040-4014
(212) 568-1500
(855) 201-3647
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
045540
NY
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
045540
NY
Other
Enumeration date
05/12/2008
Last updated
07/21/2022
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