Individual
DR. KEVIN MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
32 OLD TURNPIKE RD, NANUET, NY 10954-2446
(215) 485-8757
Mailing address
32 OLD TURNPIKE RD, NANUET, NY 10954-2446
(215) 485-8757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS037995
PA
1223P0300X
Periodontics
Primary
056313
NY
1223P0300X
Periodontics
DS037995
PA
Other
Enumeration date
11/07/2011
Last updated
09/03/2012
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