Provider Demographics
NPI:1659412708
Name:KOLOVANI-TUMMINIA, KATHRYN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:KOLOVANI-TUMMINIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6155
Mailing Address - Country:US
Mailing Address - Phone:561-736-1900
Mailing Address - Fax:561-736-1966
Practice Address - Street 1:7730 BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6155
Practice Address - Country:US
Practice Address - Phone:561-736-1900
Practice Address - Fax:561-736-1966
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15196122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist