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General NPI Number Information
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NPI Number | 1174891410
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Entity Type | Organization
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Legal Business Name | ANJALI AND KUMAR, P.C
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 63 LAKESIDE DR
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City | LEVITTOWN
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State | PA
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Zip | 19054-3901
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Country | US
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Telephone | 215-943-0213
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Fax | 215-943-0998
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Provider Business Mailing Address
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Address Line | 63 LAKESIDE DR
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City | LEVITTOWN
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State | PA
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Zip | 19054-3901
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Country | US
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Telephone | 215-943-0213
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Fax | 215-943-0998
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. DURGA TALLA
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Credential | DDS
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Telephone | 215-943-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS037590
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License Number State | PA
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