Provider Demographics
NPI:1447350459
Name:BOMZE, KURT (DDS)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:BOMZE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 MARLTON PIKE E
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2123
Mailing Address - Country:US
Mailing Address - Phone:856-424-5955
Mailing Address - Fax:856-424-8382
Practice Address - Street 1:1910 MARLTON PIKE E
Practice Address - Street 2:SUITE 9
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2123
Practice Address - Country:US
Practice Address - Phone:856-424-5955
Practice Address - Fax:856-424-8382
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ69651223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry