# MEDFORD FAMILY DENTAL CARE PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528076320
- **Authorized official:** DR. JOHN KUPCHA DDS (OWNER)
- **Authorized official phone:** (609) 654-2454

## Contact information

- **Practice address:** 308 TUCKERTON RD, MEDFORD, NJ 08055
- **Practice address phone:** (609) 654-2454
- **Practice address fax:** (609) 654-6568
- **Mailing address:** 308 TUCKERTON RD, MEDFORD, NJ 08055
- **Mailing address phone:** (609) 654-2454
- **Mailing address fax:** (609) 654-6568

## Taxonomy

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

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2885204 | — | NJ |