Provider Demographics
NPI:1235655234
Name:CHRISTY, MARC AARON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:AARON
Last Name:CHRISTY
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 1:604 MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-5141
Mailing Address - Country:US
Mailing Address - Phone:860-985-9883
Mailing Address - Fax:
Practice Address - Street 1:20 VANDERBURG RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1440
Practice Address - Country:US
Practice Address - Phone:860-985-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02684600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist