Provider Demographics
NPI:1801556949
Name:TOVILO, KRUNO (DMD)
Entity type:Individual
Prefix:DR
First Name:KRUNO
Middle Name:
Last Name:TOVILO
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 1:3119 NEWTOWN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1392
Mailing Address - Country:US
Mailing Address - Phone:718-721-5100
Mailing Address - Fax:
Practice Address - Street 1:3119 NEWTOWN AVE STE 200
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1392
Practice Address - Country:US
Practice Address - Phone:718-721-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0589221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics