Provider Demographics
NPI:1194871590
Name:DENTAL AND COSMETIC GROUP OF WESTCHESTER
Entity type:Organization
Organization Name:DENTAL AND COSMETIC GROUP OF WESTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:AMPARO
Authorized Official - Last Name:KRESTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PLLC
Authorized Official - Phone:914-683-5203
Mailing Address - Street 1:10 MITCHELL PLACE
Mailing Address - Street 2:102
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-683-5203
Mailing Address - Fax:914-289-0846
Practice Address - Street 1:10 MITCHELL PLACE
Practice Address - Street 2:102
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-683-5203
Practice Address - Fax:914-289-0846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty