Provider Demographics
NPI:1780420745
Name:KAMAL, SAFA (DMD)
Entity type:Individual
Prefix:
First Name:SAFA
Middle Name:
Last Name:KAMAL
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 1:6 JASON LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3400
Mailing Address - Country:US
Mailing Address - Phone:973-641-1452
Mailing Address - Fax:
Practice Address - Street 1:222 COMMERCE CIR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-3113
Practice Address - Country:US
Practice Address - Phone:215-458-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0447591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice