Provider Demographics
NPI:1942658869
Name:TSM1 LLC
Entity Type:Organization
Organization Name:TSM1 LLC
Other - Org Name:KID SMILE PEDIATRIC DENTISTRY AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEST
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-400-3510
Mailing Address - Street 1:318 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1644
Mailing Address - Country:US
Mailing Address - Phone:203-888-0811
Mailing Address - Fax:203-888-1870
Practice Address - Street 1:318 OXFORD RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-1644
Practice Address - Country:US
Practice Address - Phone:203-888-0811
Practice Address - Fax:203-888-1870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty