Provider Demographics
NPI:1326572348
Name:DOVER ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:DOVER ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MAAOM
Authorized Official - Phone:603-305-3401
Mailing Address - Street 1:120 OLD CAMDEN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-5523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 OLD CAMDEN RD
Practice Address - Street 2:SUITE C
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-5523
Practice Address - Country:US
Practice Address - Phone:302-531-6709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECT-0000005171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty