Larisa Ilyutovich
Larisa Ilyutovich is a General Practice Dentistry in Fort Lee, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.
- Licensed in
- NJ
- In the registry since
- 2016
Practice location Address checks out
301 Bridge Plz N Ste 2Fort Lee, NJ 07024-5059
Phone: (201) 346-4660
Fax: (201) 346-1116
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence DI020299 (NJ) |
|---|
Record details
| NPI number | 1780033225 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 6, 2016 |
| Last updated in NPPES | June 6, 2016 |
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