Provider Demographics
NPI:1760057186
Name:LILLIANA KOSTINSKI DDS PLLC
Entity Type:Organization
Organization Name:LILLIANA KOSTINSKI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIANA
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:KOSTINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:906-482-8331
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental