Provider Demographics
NPI:1194884627
Name:HAROLD M KELLNER DDS PC
Entity type:Organization
Organization Name:HAROLD M KELLNER DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:MOSHE
Authorized Official - Last Name:KELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-592-7483
Mailing Address - Street 1:92 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3200
Mailing Address - Country:US
Mailing Address - Phone:914-592-7483
Mailing Address - Fax:914-592-7686
Practice Address - Street 1:92 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3200
Practice Address - Country:US
Practice Address - Phone:914-592-7483
Practice Address - Fax:914-592-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0-21930-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty