Individual
ROMAN KHODOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5918 BERGENLINE AVE, SUITE 200, WEST NEW YORK, NJ 07093-1392
(201) 681-6555
(201) 861-2999
Mailing address
5918 BERGENLINE AVE, SUITE 200, WEST NEW YORK, NJ 07093-1392
(201) 681-6555
(201) 861-2999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02185500
NJ
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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