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General NPI Number Information
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NPI Number | 1801344486
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Entity Type | Organization
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Legal Business Name | D&K DENTAL HOLDINGS LLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 75 BARCLAY SHOPPING CTR
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2130
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Country | US
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Telephone | 610-570-1255
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Fax |
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Provider Business Mailing Address
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Address Line | 168 BARCLAY SHOPPING CTR SUITE 318
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2163
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Country | US
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Telephone | 610-570-1255
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DELINA M PARKHURST
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Credential | DMD
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Telephone | 610-570-1255
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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 | 22D102483200
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License Number State | NJ
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