Individual
DR. ALEKSANDER KHASIDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1575 BLONDELL AVE STE 150, BRONX, NY 10461-2661
(888) 700-6623
Mailing address
11150 76TH RD, FOREST HILLS, NY 11375-6454
(917) 349-3272
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041975
PA
Other
Enumeration date
03/27/2017
Last updated
10/02/2018
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