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General NPI Number Information
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NPI Number | 1952498339
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Entity Type | Organization
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Legal Business Name | ESTHETICS INC & TOOTH COUNTER CORPORATION
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 482 MAIN ST
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City | ONEONTA
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State | NY
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Zip | 13820
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Country | US
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Telephone | 607-433-1472
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Fax | 607-433-5208
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Provider Business Mailing Address
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Address Line | 482 MAIN ST
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City | ONEONTA
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State | NY
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Zip | 13820
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Country | US
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Telephone | 607-433-1472
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Fax | 607-433-5208
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PROSPER KORI BONSI
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Credential | DMD
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Telephone | 602-433-1472
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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 | 048952
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License Number State | NY
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