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NPI Code Detail

MEDICARE: DR. CHRISTOPHER LEROY KNUPP DMD

MEDICARE: DR. CHRISTOPHER LEROY KNUPP DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12050NJ

General Provider Information

NPI Number : 1114105111
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER LEROY KNUPP DMD
Provider Business Mailing Address
First Line : 44 ROOSEVELT BLVD
Second Line :
City : MARMORA
State : NJ
Zip : 08223-1402
Country : US
Telephone Number : 609-390-3998
Fax Number :
Provider Business Practice Location Address
First Line : 44 ROOSEVELT BLVD
Second Line :
City : MARMORA
State : NJ
Zip : 08223-1402
Country : US
Telephone Number : 609-390-3998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 02/01/2008

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