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General NPI Number Information
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NPI Number | 1588381685
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Entity Type | Organization
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Legal Business Name | MOUNT KISCO ORAL SURGERY PLLC
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 103 S BEDFORD RD STE 205
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3453
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Country | US
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Telephone | 914-689-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 103 S BEDFORD RD STE 205
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3453
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Country | US
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Telephone | 914-689-7550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW HOROWITZ
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Credential |
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Telephone | 917-710-1917
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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 |
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License Number State |
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