| Dr Sullivan Dr Yasner Dr Kazemi Llc | |
|
1416 Brace Road Cherry Hill NJ 08034-3523 | |
| (856) 795-8020 | |
| (856) 795-9785 |
| Full Name | Dr Sullivan Dr Yasner Dr Kazemi Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1416 Brace Road, Cherry Hill, New Jersey |
| Authorized Official Name and Position | Michael Yasner (PARTNER) |
| Authorized Official Contact | 8567958020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sullivan Dr Yasner Dr Kazemi Llc 1416 Brace Road Cherry Hill NJ 08034-3523 Ph: (856) 795-8020 | Dr Sullivan Dr Yasner Dr Kazemi Llc 1416 Brace Road Cherry Hill NJ 08034-3523 Ph: (856) 795-8020 |
| NPI Number | 1700941028 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700941028 | NPI | - | NPPES |
| 567 | Other | PA | UNITED CONCORDIA |
| 11133 | Other | NJ | DELTA DENTAL |
| 3399001 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (New Jersey) | Primary |
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