Organization
ILYA MILOSLAVSKIY DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILYA MILOSLAVSKIY DDS (PRESIDENT)
(917) 658-4575
Entity
Organization
Contact information
Practice address
2364 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10027-3640
(917) 658-4575
Mailing address
2364 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10027-3640
(917) 658-4575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052222
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02771488
—
NY
Enumeration date
06/28/2011
Last updated
06/28/2011
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