Provider Demographics
NPI:1376767806
Name:SEVERE, MARTHA CLAUDE-ELLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:CLAUDE-ELLA
Last Name:SEVERE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MURRAY HILL TER
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3014
Mailing Address - Country:US
Mailing Address - Phone:917-586-5612
Mailing Address - Fax:
Practice Address - Street 1:935 GARFIELD AVE FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2731
Practice Address - Country:US
Practice Address - Phone:201-478-5800
Practice Address - Fax:201-478-5814
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052622-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist