Individual
IFRAIM AGABABAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
760 BROADWAY, 2C-320, BROOKLYN, NY 11206-5317
(718) 963-8308
Mailing address
435 OCEAN PKWY APT 2D, BROOKLYN, NY 11218-5165
(347) 962-0454
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058140
NY
Other
Enumeration date
11/19/2014
Last updated
08/14/2015
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