Organization
ELEVATION DENTAL STUDIO, DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITZ-ANN EDMOND DMD (DENTIST / OWNER)
(914) 259-8559
Entity
Organization
Contact information
Practice address
545 GRAMATAN AVE UNIT B, MOUNT VERNON, NY 10552-2103
(914) 259-8559
Mailing address
545 GRAMATAN AVE UNIT B, MOUNT VERNON, NY 10552-2103
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03232928
—
NY
01
—
1740516525
INDIVIDUAL NPI
—
Enumeration date
09/24/2019
Last updated
03/07/2023
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