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Individual

ILYA MILOSLAVSKIY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1130 140TH AVE NE STE 100B, BELLEVUE, WA 98005
(425) 746-6090
(425) 747-9856
Mailing address
313 AVENUE OF THE AMERICAS, APT. 1A, NEW YORK, NY 10014-4445
(917) 658-4575

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
052222
NY
1223P0700X
Prosthodontics
60452580
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02771488
NY
Enumeration date
02/17/2007
Last updated
06/07/2018
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