Most Relevant Information
Provider Data
| NPI Number: | 1003375759 |
| Provider Name: | ISRAEL SHIMUNOV DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/12/2019 |
| Last Updated: | 06/10/2021 |
Provider Practice Location
9815 65TH RD APT 1B
REGO PARK
NY
113743505
Practice Location Phone/Fax
| Phone: | 3472476810 |
| Fax: |
Provider Mailing Location
6259 108TH ST APT 5H
FOREST HILLS
NY
113751314
Provider Mailing Phone/Fax
| Phone: | 3472476810 |
| Fax: |