Organization
DENTIST 4 U
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA LOPATNYUK (PRESIDENT)
(845) 331-9150
Entity
Organization
Contact information
Practice address
186 BROADWAY, PORT EWEN, NY 12466
(845) 331-9150
(845) 331-8846
Mailing address
58 JEFFERSON ST, HIGHLAND MILLS, NY 10930-2726
(845) 928-4723
(845) 928-4723
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
044997-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02382396
—
NY
Enumeration date
08/08/2007
Last updated
08/08/2007
Update your record
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