Provider Demographics
NPI:1922077957
Name:KAUFMAN, MARC P (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:P
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 HILL BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-1502
Mailing Address - Country:US
Mailing Address - Phone:914-962-6444
Mailing Address - Fax:914-962-3904
Practice Address - Street 1:3630 HILL BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1502
Practice Address - Country:US
Practice Address - Phone:914-962-6444
Practice Address - Fax:914-962-3904
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice