Provider Demographics
NPI:1750731634
Name:GEIST, KRISTEN L (DDS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:GEIST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:VOORHEESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12186-0366
Mailing Address - Country:US
Mailing Address - Phone:518-765-4616
Mailing Address - Fax:
Practice Address - Street 1:17 MAPLE ROAD
Practice Address - Street 2:
Practice Address - City:VOORHEESVILLE
Practice Address - State:NY
Practice Address - Zip Code:12186-0366
Practice Address - Country:US
Practice Address - Phone:518-765-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist