Organization
ASTORIA DENTAL TOWN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAKOV FUZAYLOV DDS (PRESIDENT)
(917) 202-0190
Entity
Organization
Contact information
Practice address
3060 STEINWAY ST FL 2, ASTORIA, NY 11103-3854
(718) 278-2141
Mailing address
3060 STEINWAY ST FL 2, ASTORIA, NY 11103-3854
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
055027
NY
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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