Provider Demographics
NPI:1124362629
Name:SUNIL KUMAR DMD PC
Entity Type:Organization
Organization Name:SUNIL KUMAR DMD PC
Other - Org Name:FAIRMONT DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-435-1288
Mailing Address - Street 1:1414 W FAIRMONT ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-1021
Mailing Address - Country:US
Mailing Address - Phone:610-435-1288
Mailing Address - Fax:610-435-5451
Practice Address - Street 1:1414 W FAIRMONT ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-1021
Practice Address - Country:US
Practice Address - Phone:610-435-1288
Practice Address - Fax:610-435-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty