Organization
ADVANCED DENTISTRY DENTAL OFFICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LIKHOLETOVA DDS (PRESIDENT)
(718) 934-9494
Entity
Organization
Contact information
Practice address
3051 OCEAN AVE, SUITE A10, BROOKLYN, NY 11235
(718) 934-9494
(718) 891-6439
Mailing address
3051 OCEAN AVE, SUITE A10, BROOKLYN, NY 11235
(718) 934-9494
(718) 891-6439
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0467811
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01688646
—
NY
Enumeration date
04/23/2007
Last updated
08/03/2010
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