Provider Demographics
NPI:1235763418
Name:MINT KISCO DENTAL P.C.
Entity Type:Organization
Organization Name:MINT KISCO DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-260-5826
Mailing Address - Street 1:276 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:POUND RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576-1320
Mailing Address - Country:US
Mailing Address - Phone:914-260-5826
Mailing Address - Fax:
Practice Address - Street 1:195 N BEDFORD RD STE 7
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1149
Practice Address - Country:US
Practice Address - Phone:914-241-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty