Individual
AVRAHAM KOLONTAROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1502 E 14TH ST, BROOKLYN, NY 11230-7283
(718) 709-4611
Mailing address
8410 126TH ST APT 2, KEW GARDENS, NY 11415-2206
(347) 430-7582
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
061926
NY
Other
Enumeration date
06/03/2020
Last updated
12/07/2023
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