Organization
MERMAID DENTAL ARTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANATOLIY KONOVALOV D.M.D. (OWNER)
(718) 373-0300
Entity
Organization
Contact information
Practice address
2423 MERMAID AVE, BROOKLYN, NY 11224-2374
(718) 373-0300
(718) 373-0570
Mailing address
2423 MERMAID AVE, BROOKLYN, NY 11224-2374
(718) 373-0300
(718) 373-0570
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054967
NY
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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