# VIDYA KINI KUKKUNDUR, DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VIDYA KINI KUKKUNDUR, DDS PC
- **Other names:** South Jersey Center for Dental Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003582883
- **Legal business name:** VIDYA KINI KUKKUNDUR, DDS PC
- **Authorized official:** DR. VIDYA KINI KUKKUNDUR DDS (CEO)
- **Authorized official phone:** (856) 872-2622

## Contact information

- **Practice address:** 525 ROUTE 73 S STE 105, MARLTON, NJ 08053-9643
- **Practice address phone:** (856) 872-2622
- **Practice address fax:** (856) 596-1726
- **Mailing address:** 2 PENDLETON CT, MEDFORD, NJ 08055-8503
- **Mailing address phone:** (609) 903-0135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2021
- **Last updated:** 08/20/2021