Provider Demographics
NPI:1750669800
Name:LITMAN, JEFFREY DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:LITMAN
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 1:475 OLD MARLTON PIKE W STE 1
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2089
Mailing Address - Country:US
Mailing Address - Phone:856-983-0202
Mailing Address - Fax:856-983-8990
Practice Address - Street 1:475 MARLTON PIKE W
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2098
Practice Address - Country:US
Practice Address - Phone:856-983-0202
Practice Address - Fax:856-983-8990
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024472001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty