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General NPI Number Information
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NPI Number | 1093066581
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Entity Type | Organization
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Legal Business Name | DR KOSLOVSKY DDS PC
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 800B 5TH AVE STE 1
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City | NEW YORK
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State | NY
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Zip | 10065-7277
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Country | US
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Telephone | 212-888-4760
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Fax | 212-888-4710
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Provider Business Mailing Address
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Address Line | 800B 5TH AVE STE 1
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City | NEW YORK
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State | NY
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Zip | 10065-7277
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Country | US
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Telephone | 646-734-3929
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Fax | 212-888-4710
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Authorized Official
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Title or Position | OWNER
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Name | DAVID KOSLOVSKY
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Credential | DDS, FACS
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Telephone | 646-734-3929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 054954
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License Number State | NY
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