Provider Demographics
NPI:1821221094
Name:TUMMINIA DENTAL ASSOCIATES
Entity type:Organization
Organization Name:TUMMINIA DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOLOVANI-TUMMINIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-736-1900
Mailing Address - Street 1:7730 BOYNTON BEACH BLVD
Mailing Address - Street 2:STE 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:STE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 151961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty