Individual
DR. ANDREY IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
575 FULTON ST, 2ND FLOOR, BROOKLYN, NY 11201-5309
(718) 596-5378
Mailing address
803 PLAZA DR, WOODBRIDGE, NJ 07095-1114
(732) 636-7624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
049734
NY
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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