Provider Demographics
NPI:1518106277
Name:COSMETIC DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:COSMETIC DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-684-7045
Mailing Address - Street 1:1230 MAMARONECK AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5229
Mailing Address - Country:US
Mailing Address - Phone:914-684-7045
Mailing Address - Fax:914-684-7047
Practice Address - Street 1:1230 MAMARONECK AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-5229
Practice Address - Country:US
Practice Address - Phone:914-684-7045
Practice Address - Fax:914-684-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03846011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty