Provider Demographics
NPI:1164319307
Name:THE CENTER FOR COMPLETE HEALTH DENTISTRY @ WILTON
Entity type:Organization
Organization Name:THE CENTER FOR COMPLETE HEALTH DENTISTRY @ WILTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTRZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-762-5800
Mailing Address - Street 1:27 DANBURY RD FL 3
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4405
Mailing Address - Country:US
Mailing Address - Phone:203-762-5800
Mailing Address - Fax:
Practice Address - Street 1:27 DANBURY RD FL 3
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4405
Practice Address - Country:US
Practice Address - Phone:203-762-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty