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General NPI Number Information
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NPI Number | 1477970267
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Entity Type | Individual
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Provider Name | ELIZABETH KAMINSKY DMD
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Gender | Female
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 115 VILLAGE PLACE
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City | DILLON
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-468-5995
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Fax | 970-513-0494
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Provider Business Mailing Address
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Address Line | 24 MAGUIRE RD
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City | WAYLAND
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State | MA
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Zip | 01778-4725
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Country | US
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Telephone | 508-655-0024
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Fax | 508-655-6624
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60561975
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN1857192
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DEN.00203855
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License Number State | CO
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