MEDICARE: DR. KATHRYN E KOLOVANI-TUMMINIA 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
1	122300000X	Dentist	DN15196	FL

General Provider Information

NPI Number	:	1659412708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN E KOLOVANI-TUMMINIA DMD

Provider Business Mailing Address
First Line	:	7730 BOYNTON BEACH BLVD
Second Line	:	SUITE 6
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-6155
Country	:	US
Telephone Number	:	561-736-1900
Fax Number	:	561-736-1966

Provider Business Practice Location Address
First Line	:	7730 BOYNTON BEACH BLVD
Second Line	:	SUITE 6
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-6155
Country	:	US
Telephone Number	:	561-736-1900
Fax Number	:	561-736-1966

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	07/08/2007

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