Provider Demographics
NPI:1326161928
Name:MARGOLIN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:MARGOLIN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-567-0405
Mailing Address - Street 1:620 E PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-1801
Mailing Address - Country:US
Mailing Address - Phone:201-567-0405
Mailing Address - Fax:201-541-7070
Practice Address - Street 1:620 E PALISADE AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-1801
Practice Address - Country:US
Practice Address - Phone:201-567-0405
Practice Address - Fax:201-541-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174291223G0001X
NJ174281223G0001X
NY65041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0241008Medicaid