Individual
IGOR KOROTUN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
90-79 SUTPHIN BLVD, JAMAICA, NY 11435
(718) 657-5068
(718) 526-5930
Mailing address
90-79 SUTPHIN BLVD, JAMAICA, NY 11435
(718) 657-5068
(718) 526-5930
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
044363
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01433325
—
NY
Enumeration date
01/25/2006
Last updated
07/08/2007
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