Provider Demographics
NPI:1326166695
Name:KIVOWITZ, GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:KIVOWITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PENN'S TRAIL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:212-371-1971
Mailing Address - Fax:212-685-4939
Practice Address - Street 1:12 PENN'S TRAIL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:212-371-1971
Practice Address - Fax:212-685-4939
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025364-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice