Individual
MIKHAIL ROEL SEGURITAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
57 W 58TH ST, 2, NEW YORK, NY 10019-1630
(212) 688-2452
(212) 223-8126
Mailing address
57 W 58TH ST, 2, NEW YORK, NY 10019-1630
(212) 688-2452
(212) 223-8126
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045789
NY
1223G0001X
General Practice Dentistry
045789
NY
Other
Enumeration date
02/12/2007
Last updated
11/20/2013
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