Individual
ELVIRA YAKUBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6612 102ND ST APT 1E, REGO PARK, NY 11374-4524
(718) 997-6660
(718) 997-8118
Mailing address
6612 102STREET SUITE1E, REGO PARK, NY 11435
(718) 997-6660
(718) 991-8118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048679-1
NY
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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