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General NPI Number Information
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NPI Number | 1083827430
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Entity Type | Organization
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Legal Business Name | DENTOFACIAL ASSOCIATES,PA
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 435 W. LANDIS AVENUE
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-691-3220
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Fax | 856-507-9731
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Provider Business Mailing Address
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Address Line | 435 W. LANDIS AVENUE
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City | VINELAND
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State | NJ
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Zip | 08360
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Country | US
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Telephone | 856-691-3220
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Fax | 856-507-9731
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Authorized Official
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Title or Position | DENTIST
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Name | JOSE A CUMBA
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Credential | DMD
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Telephone | 856-691-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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