Provider Demographics
NPI:1417657354
Name:FOREHAND, KRISTEN N (DMD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:N
Last Name:FOREHAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 STATE ROUTE 55 STE 107
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5048
Mailing Address - Country:US
Mailing Address - Phone:845-486-4572
Mailing Address - Fax:845-559-0627
Practice Address - Street 1:1110 STATE ROUTE 55 STE 107
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5048
Practice Address - Country:US
Practice Address - Phone:845-486-4572
Practice Address - Fax:845-559-0627
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064207-01122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist