Provider Demographics
NPI:1285058578
Name:CIGNA AND KROBOTH ORTHODONTICS
Entity type:Organization
Organization Name:CIGNA AND KROBOTH ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KROBOTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-227-7880
Mailing Address - Street 1:1123 ROUTE 82
Mailing Address - Street 2:PO BOX 127
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6206
Mailing Address - Country:US
Mailing Address - Phone:845-227-7880
Mailing Address - Fax:845-227-2804
Practice Address - Street 1:1123 ROUTE 82
Practice Address - Street 2:POST OFFICE BOX 127
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6206
Practice Address - Country:US
Practice Address - Phone:845-227-7880
Practice Address - Fax:845-227-2804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0558731223X0400X
NY0385511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty