Provider Demographics
NPI:1255627576
Name:BOTTINO, FRANK (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:BOTTINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 N BEDFORD RD STE 7
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1149
Mailing Address - Country:US
Mailing Address - Phone:914-241-5555
Mailing Address - Fax:
Practice Address - Street 1:195 N BEDFORD RD STE 7
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1149
Practice Address - Country:US
Practice Address - Phone:914-241-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011185122300000X
NJ22DI024712001223G0001X
NY057238-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice