Individual
KIMIA KOHANBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1411 CONEY ISLAND AVE, BROOKLYN, NY 11230-4137
(718) 484-1560
Mailing address
1411 CONEY ISLAND AVE, BROOKLYN, NY 11230-4137
(718) 484-1560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061483
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2019
Last updated
02/09/2024
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