Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22DI02191300 | NJ |
NPI | 1013016872 |
---|---|
Provider Name | Dr. Kevin Vincent Atlee |
First Address | Turnersville, NJ 08012-5826 |
Second Address | Moorestown, NJ 08057-2367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |