Individual
BORIS SULEYMANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5225 N 19TH AVE # UINTC, PHOENIX, AZ 85015-2903
(602) 433-0313
Mailing address
5225 N 19TH AVE # UINTC, PHOENIX, AZ 85015-2903
(602) 433-0313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011036
AZ
1223G0001X
General Practice Dentistry
060434-01
NY
Other
Enumeration date
08/04/2019
Last updated
02/03/2022
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