Provider Demographics
NPI:1710588066
Name:KAY, MARC CHRISTIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC CHRISTIAN
Middle Name:
Last Name:KAY
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 1:340 W 28TH ST APT 9J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4741
Mailing Address - Country:US
Mailing Address - Phone:917-436-0832
Mailing Address - Fax:
Practice Address - Street 1:1626 RTE 130
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3000
Practice Address - Country:US
Practice Address - Phone:267-469-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0620001223P0300X
NJ22DI02746900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI02746900OtherNEW JERSEY BOARD OF DENTISTRY