Medford Family Dental Care PA
Dentist in Medford, NJ. Organization (NPI-2).
NPI number1528076320
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1528076320
- Entity type
- Organization (NPI-2)
- Legal business name
- Medford Family Dental Care PA
- Organization subpart
- No
- Enumeration date
- Aug 4, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
308 Tuckerton RdMedford, NJ 08055
Phone 609-654-2454 · Fax 609-654-6568
Mailing address
308 Tuckerton RdMedford, NJ 08055
Phone 609-654-2454 · Fax 609-654-6568
Authorized official
John Kupcha
Owner
6096542454
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All 19 Dentist providers in Medford · All 762 providers in Medford
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