Provider Demographics
NPI:1376644765
Name:DAVID J. MARTIN, DDS, PA
Entity Type:Organization
Organization Name:DAVID J. MARTIN, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERRAIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-942-6467
Mailing Address - Street 1:336 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2554
Mailing Address - Country:US
Mailing Address - Phone:973-942-6467
Mailing Address - Fax:
Practice Address - Street 1:336 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2554
Practice Address - Country:US
Practice Address - Phone:973-942-6467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ063101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty