Provider Demographics
NPI:1073534566
Name:KAUFMAN, MARVIN A (DDS)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:A
Last Name:KAUFMAN
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 1:94 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1036
Mailing Address - Country:US
Mailing Address - Phone:732-536-2020
Mailing Address - Fax:732-536-2199
Practice Address - Street 1:94 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1036
Practice Address - Country:US
Practice Address - Phone:732-536-2020
Practice Address - Fax:732-536-2199
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008320001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice