Provider Demographics
NPI:1891984027
Name:MACDERMOTT, MARTIN CORMAC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CORMAC
Last Name:MACDERMOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:360 FURMAN ST
Mailing Address - Street 2:#940
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:917-562-9964
Mailing Address - Fax:866-221-4121
Practice Address - Street 1:119 MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3464
Practice Address - Country:US
Practice Address - Phone:718-855-2855
Practice Address - Fax:866-221-4121
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0524481223P0221X
CT0097311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry