Provider Demographics
NPI:1558159574
Name:NEW TOWN DENTAL
Entity type:Organization
Organization Name:NEW TOWN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-223-1945
Mailing Address - Street 1:10 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9401
Mailing Address - Country:US
Mailing Address - Phone:856-223-1945
Mailing Address - Fax:856-223-1947
Practice Address - Street 1:10 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9401
Practice Address - Country:US
Practice Address - Phone:856-223-1945
Practice Address - Fax:856-223-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1063134476OtherDO NOT ACCEPT MEDICAID OR MEDICARE
NJ1285783043OtherDO NOT ACCEPT MEDICAID OR MEDICARE