| Port Chester Kid Smiles | |
|
245 N Broadway Ste 108 Sleepy Hollow NY 10591-2657 | |
| (914) 332-1272 | |
| (914) 332-1261 |
| Full Name | Port Chester Kid Smiles |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 245 N Broadway Ste 108, Sleepy Hollow, New York |
| Authorized Official Name and Position | Rossarin Mitsumoto (OWNER) |
| Authorized Official Contact | 9143321272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Chester Kid Smiles 245 N Broadway Ste 108 Sleepy Hollow NY 10591-2657 Ph: (914) 332-1272 | Port Chester Kid Smiles 245 N Broadway Ste 108 Sleepy Hollow NY 10591-2657 Ph: (914) 332-1272 |
| NPI Number | 1316467269 |
|---|---|
| Provider Enumeration Date | 06/21/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316467269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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