Provider Demographics
NPI:1194934851
Name:KMAY DENTAL PC
Entity type:Organization
Organization Name:KMAY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-978-7440
Mailing Address - Street 1:853 MILL CREEK RD
Mailing Address - Street 2:SUITE NUMBER 7 & 8
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-4562
Mailing Address - Country:US
Mailing Address - Phone:609-978-7440
Mailing Address - Fax:609-978-5498
Practice Address - Street 1:853 MILL CREEK RD
Practice Address - Street 2:SUITE NUMBER 7 & 8
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-4562
Practice Address - Country:US
Practice Address - Phone:609-978-7440
Practice Address - Fax:609-978-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0162891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty