Organization
1037 FULTON STREET DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DAVYDOV (DIRECTOR)
(347) 528-8164
Entity
Organization
Contact information
Practice address
1037 FULTON ST, FARMINGDALE, NY 11735-4700
(347) 528-8164
Mailing address
1037 FULTON ST, FARMINGDALE, NY 11735-4700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
10/23/2018
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