Provider Demographics
NPI:1124118336
Name:KAZMIERSKI-FURNO, ERIN R (DMD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:KAZMIERSKI-FURNO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:R
Other - Last Name:KAZMIERSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2141
Mailing Address - Country:US
Mailing Address - Phone:856-596-1933
Mailing Address - Fax:856-596-4001
Practice Address - Street 1:64 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2141
Practice Address - Country:US
Practice Address - Phone:856-596-1933
Practice Address - Fax:856-596-4001
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021627001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics