Provider Demographics
NPI:1922159946
Name:VANMARCKE, MARGARET (DMD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:VANMARCKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARGARETHA
Other - Middle Name:
Other - Last Name:VANMARCKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:301 N HARRISON ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3512
Mailing Address - Country:US
Mailing Address - Phone:609-924-0796
Mailing Address - Fax:609-924-7166
Practice Address - Street 1:301 N HARRISON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3512
Practice Address - Country:US
Practice Address - Phone:609-924-0796
Practice Address - Fax:609-924-7166
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015303001223G0001X
PADS030467L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017917790003Medicaid