Provider Demographics
NPI:1194867705
Name:JONI R MARCUS & ASSOC
Entity Type:Organization
Organization Name:JONI R MARCUS & ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-365-0577
Mailing Address - Street 1:7215 PASSYUNK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-1525
Mailing Address - Country:US
Mailing Address - Phone:215-727-1800
Mailing Address - Fax:215-365-1493
Practice Address - Street 1:7215 PASSYUNK AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19142-1525
Practice Address - Country:US
Practice Address - Phone:215-727-1800
Practice Address - Fax:215-365-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-030626 L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty