Individual
EMMANUEL KHANIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1492 E 18TH ST, BROOKLYN, NY 11230-6706
(718) 737-8324
Mailing address
1492 E 18TH ST, BROOKLYN, NY 11230-6706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
060405
NY
Other
Enumeration date
03/25/2018
Last updated
05/23/2020
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