Organization
DOWNTOWN DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YULIAN AMINOV (PRESIDENT)
(212) 203-1611
Entity
Organization
Contact information
Practice address
1023 MAIN ST, 1ST FLOOR, BRIDGEPORT, CT 06604-4221
(212) 203-1611
Mailing address
9919 66TH RD, APT # 3 A, REGO PARK, NY 11374-4458
(212) 203-1611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010859
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008042136
—
CT
Enumeration date
05/13/2013
Last updated
05/13/2013
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