Organization
ADVANCED BRONX DENTAL PLLC
Active
Other names
Advanced Bronx Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER MUSHEYEV (DIRECTOR)
(718) 292-6209
Entity
Organization
Contact information
Practice address
237 WILLIS AVE, BRONX, NY 10454-2678
(718) 292-6209
Mailing address
237 WILLIS AVE, BRONX, NY 10454-2678
(718) 292-6209
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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