Organization
DR SULLIVAN DR YASNER DR KAZEMI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL YASNER DMD (PARTNER)
(856) 795-8020
Entity
Organization
Contact information
Practice address
1416 BRACE ROAD, CHERRY HILL, NJ 08034-3523
(856) 795-8020
(856) 795-9785
Mailing address
1416 BRACE ROAD, CHERRY HILL, NJ 08034-3523
(856) 795-8020
(856) 795-9785
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11133
DELTA DENTAL
NJ
05
—
3399001
—
NJ
01
—
567
UNITED CONCORDIA
PA
Enumeration date
12/27/2006
Last updated
08/22/2020
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