Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DEN1001158 | DC |
NPI | 1033479464 |
---|---|
Provider Name | Dr. Bob Kumra |
First Address | Washington, DC 20036-3614 |
Second Address | Washington, DC 20036-3614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2012 |
Last Update Date | 15/10/2015 |