Individual
BENJAMIN YUCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
99 W MAIN ST, MOORESTOWN, NJ 08057-2429
(856) 234-4044
Mailing address
99 W MAIN ST, MOORESTOWN, NJ 08057-2429
(856) 234-4044
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02664000
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS041146
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103255463
—
PA
Enumeration date
02/09/2017
Last updated
05/01/2018
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