Individual
EVELINA DAVYDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
119 W 57TH ST STE 512, NEW YORK, NY 10019-2302
(347) 702-3052
Mailing address
10849 63RD AVE APT 1P, FOREST HILLS, NY 11375-1360
(347) 702-3052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060590-01
NY
122300000X
Dentist
12612
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/18/2018
Last updated
09/13/2023
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