Provider Demographics
NPI:1407876790
Name:MOSTOWY, CYNTHIA LORAH (AS, BS, RDH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LORAH
Last Name:MOSTOWY
Suffix:
Gender:F
Credentials:AS, BS, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1506
Mailing Address - Country:US
Mailing Address - Phone:860-961-7557
Mailing Address - Fax:
Practice Address - Street 1:335 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1506
Practice Address - Country:US
Practice Address - Phone:860-961-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4086124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist