DR. Irina Kazbanov, DMD

NPI #1215218649 in Edgewater, New Jersey

Provider Information

NPI Number: 1215218649
Entity Type: Individual
Name: DR. Irina Kazbanov, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Aug 30, 2011
Last Updated: Oct 23, 2012

Practice Location

Address: 93 MYRTLE AVE
Address 2: APT 2
City: Edgewater
State: New Jersey
ZIP Code: 07020-1411
Phone: (917) 532-0226

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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