Organization
GORGEOS SMILE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA GABRILYANTS DDS (DENTIST)
(718) 299-5900
Entity
Organization
Contact information
Practice address
871 E TREMONT AVE, BRONX, NY 10460-4207
(718) 299-5900
Mailing address
871 E TREMONT AVE, BRONX, NY 10460-4207
(718) 299-5900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02832882
—
NY
Enumeration date
03/04/2008
Last updated
03/04/2008
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