Provider Demographics
NPI:1265459820
Name:LEMPERT, SUSAN MARA (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARA
Last Name:LEMPERT
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:553 BECKETT RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1565
Mailing Address - Country:US
Mailing Address - Phone:856-241-8400
Mailing Address - Fax:856-241-8408
Practice Address - Street 1:553 BECKETT RD
Practice Address - Street 2:SUITE 404
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1565
Practice Address - Country:US
Practice Address - Phone:856-241-8400
Practice Address - Fax:856-241-8408
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020407021223X0400X
PADS030509L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics