Provider Demographics
NPI:1588955777
Name:MOUNT KISCO DENTAL GROUP PLLC
Entity type:Organization
Organization Name:MOUNT KISCO DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:VEECE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:270-715-0331
Mailing Address - Street 1:293 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2765
Mailing Address - Country:US
Mailing Address - Phone:270-715-0331
Mailing Address - Fax:270-721-0505
Practice Address - Street 1:293 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2765
Practice Address - Country:US
Practice Address - Phone:270-715-0331
Practice Address - Fax:270-721-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty