Individual
MARKO WSEWOLOD LUTZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
30 EAST 40TH STREET, SUITE 706, NEW YORK, NY 10016
(212) 697-8178
Mailing address
39-26 65TH STREET, WOODSIDE, NY 11377-3638
(212) 697-8178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
037691-1
NY
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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