# BREWSTER FAMILY DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528776630
- **Authorized official:** DR. BALU M KRISHNA DDS (OWNER)
- **Authorized official phone:** (917) 696-8537

## Contact information

- **Practice address:** 504 N MAIN ST, BREWSTER, NY 10509-1230
- **Practice address phone:** (845) 279-3482
- **Practice address fax:** (845) 278-1782
- **Mailing address:** 504 N MAIN ST, BREWSTER, NY 10509-1230
- **Mailing address phone:** (845) 279-3482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/08/2022
- **Last updated:** 11/08/2022