Provider Demographics
NPI:1003888686
Name:KOROL, TATIANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:KOROL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 OCEAN PKWY
Mailing Address - Street 2:#301
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-333-1144
Mailing Address - Fax:718-333-0695
Practice Address - Street 1:3049 OCEAN PKWY
Practice Address - Street 2:#301
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-333-1144
Practice Address - Fax:718-333-0695
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0454141122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist