Provider Demographics
NPI:1184833410
Name:MARCANTONIS, GEORGE (DMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:MARCANTONIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 YORKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-4203
Mailing Address - Country:US
Mailing Address - Phone:609-319-8834
Mailing Address - Fax:
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE L-3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-629-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02225100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist