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Organization

BREWSTER FAMILY DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BALU M KRISHNA DDS (OWNER)
(917) 696-8537
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04513535
NY
Enumeration date
11/08/2022
Last updated
11/08/2022
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