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General NPI Number Information
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NPI Number | 1285058578
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Entity Type | Organization
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Legal Business Name | CIGNA AND KROBOTH ORTHODONTICS
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 02/07/2014
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Provider Practice Location Address
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Address Line | 1123 ROUTE 82 POST OFFICE BOX 127
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-6206
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Country | US
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Telephone | 845-227-7880
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Fax | 845-227-2804
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Provider Business Mailing Address
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Address Line | 1123 ROUTE 82 PO BOX 127
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-6206
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Country | US
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Telephone | 845-227-7880
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Fax | 845-227-2804
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. TAMARA KROBOTH
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Credential | DDS
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Telephone | 845-227-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 055873
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 038551
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License Number State | NY
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