Organization
LILIYA ETKINA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIYA ETKINA DDS (DENTIST/OWNER)
(718) 937-7722
Entity
Organization
Contact information
Practice address
4528 21ST STREET, LONG ISLAND CITY, NY 11101
(718) 937-7722
Mailing address
45-28 21ST STREET, LONG ISLAND CITY, NY 11101
(718) 937-7722
(718) 937-7729
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
C50603
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
057328
NY
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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