Individual
DR. DANIEL KHODORKOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30 E 60TH ST STE 608, NEW YORK, NY 10022-1038
(347) 566-0219
Mailing address
100 OLD PALISADE RD APT 3711, FORT LEE, NJ 07024-7028
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062684-01
NY
Other
Enumeration date
05/01/2020
Last updated
10/08/2024
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