Provider Demographics
NPI:1942424015
Name:MARMO, JAMES VINCENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VINCENT
Last Name:MARMO
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 1:8 OLD REPUBLIC LN
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4619
Mailing Address - Country:US
Mailing Address - Phone:856-988-9692
Mailing Address - Fax:
Practice Address - Street 1:250 GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-4187
Practice Address - Country:US
Practice Address - Phone:856-783-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI021706001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice