Provider Demographics
NPI:1265734693
Name:THE CENTER FOR COSMETIC DENTISTRY
Entity type:Organization
Organization Name:THE CENTER FOR COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIOSECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-761-8229
Mailing Address - Street 1:147 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2539
Mailing Address - Country:US
Mailing Address - Phone:914-761-8229
Mailing Address - Fax:
Practice Address - Street 1:147 UNDERHILL AVE
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10604-2539
Practice Address - Country:US
Practice Address - Phone:914-761-8229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty