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General NPI Number Information
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NPI Number | 1467092965
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Entity Type | Organization
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Legal Business Name | NYC IMPLANT AND ORAL SURGERY PC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 30 E 60TH ST STE 907
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City | NEW YORK
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State | NY
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Zip | 10022-1058
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Country | US
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Telephone | 212-606-2345
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Fax | 646-687-6938
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Provider Business Mailing Address
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Address Line | 30 E 60TH ST STE 907
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City | NEW YORK
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State | NY
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Zip | 10022-1058
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Country | US
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Telephone | 212-606-2345
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Fax | 646-687-6938
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIKHAIL RUVINSKY
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Credential | MD, DDS, RPH.
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Telephone | 212-606-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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