Individual
JIVKO GUEORGUIEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3198
(718) 240-6552
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3198
(718) 240-6552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062383
NY
1223G0001X
General Practice Dentistry
D11979
OR
Other
Enumeration date
04/16/2020
Last updated
05/26/2024
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