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General NPI Number Information
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NPI Number | 1487969937
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Entity Type | Organization
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Legal Business Name | MIKHAIL RUVINSKY DDS, PC
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 2973 OCEAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-3201
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Country | US
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Telephone | 718-332-0300
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Fax | 718-332-0302
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Provider Business Mailing Address
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Address Line | 2973 OCEAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-3201
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Country | US
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Telephone | 718-332-0300
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Fax | 718-332-0302
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIKHAIL RUVINSKY
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Credential | MD, DDS, RPH
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Telephone | 718-332-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 051307
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License Number State | NY
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