Individual
DR. INESSA KANDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
21333 39TH AVE STE 300, BAYSIDE, NY 11361-2092
(718) 734-2888
(718) 734-2899
Mailing address
21333 39TH AVE STE 300, BAYSIDE, NY 11361-2092
(718) 734-2888
(718) 734-2899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
056061
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
056061
NY
Other
Enumeration date
07/19/2012
Last updated
05/06/2020
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