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General NPI Number Information
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NPI Number | 1184177537
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Entity Type | Organization
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Legal Business Name | Y. KUMAR DMD LLC
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 10431 ACADEMY RD STE K
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1137
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Country | US
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Telephone | 973-309-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 423 LAUREL CREEK BLVD
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3970
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Country | US
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Telephone | 973-309-3334
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. YASHODHARA KUMAR
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Credential | DMD
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Telephone | 973-309-3334
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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 | S038551
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License Number State | PA
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