Organization
MEDFORD FAMILY DENTAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KUPCHA DDS (OWNER)
(609) 654-2454
Entity
Organization
Contact information
Practice address
308 TUCKERTON RD, MEDFORD, NJ 08055
(609) 654-2454
(609) 654-6568
Mailing address
308 TUCKERTON RD, MEDFORD, NJ 08055
(609) 654-2454
(609) 654-6568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2885204
—
NJ
Enumeration date
08/04/2006
Last updated
08/22/2020
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