Individual
MARINA KRISTIN KANAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 BURTON LN STE 400, MULLICA HILL, NJ 08062-9441
(856) 842-5400
Mailing address
4 BURTON LN STE 400, MULLICA HILL, NJ 08062-9441
(856) 842-5400
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02961600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
13099
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2021
Last updated
07/05/2023
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