Victoria Dental Pllc

NPI #1689972473 in Astoria, New York

Provider Information

NPI Number: 1689972473
Entity Type: Organization
Organization Name: Victoria Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 3, 2011
Last Updated: Mar 3, 2011

Practice Location

Address: 3118 STEINWAY ST
City: Astoria
State: New York
ZIP Code: 11103-3909
Phone: (718) 728-7812

Authorized Official

Name: DR. ROBERT FATAKHOV, DDS
Title: DENTIST/MEMBER
Phone: (917) 291-4232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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