Provider Demographics
NPI:1619189099
Name:KOSTINSKI, LILLIANA GUZMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LILLIANA
Middle Name:GUZMAN
Last Name:KOSTINSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 W SHARON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-1970
Mailing Address - Country:US
Mailing Address - Phone:906-482-8331
Mailing Address - Fax:906-523-9993
Practice Address - Street 1:706 W SHARON AVE STE 3
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-1970
Practice Address - Country:US
Practice Address - Phone:906-482-8331
Practice Address - Fax:906-523-9993
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010154671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice