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Individual

HATTANAS KUMCHAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
909 WALNUT ST RM 300, PHILADELPHIA, PA 19107-5211
(215) 503-6215
Mailing address
3411 CHESTNUT ST APT 509, PHILADELPHIA, PA 19104-5519
(857) 210-2390

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
05/30/2019
Last updated
05/30/2019
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