Provider Demographics
NPI:1992038608
Name:MARCUS, DAVID JOSHUA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSHUA
Last Name:MARCUS
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 1:510 E 23RD ST
Mailing Address - Street 2:APT #1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5012
Mailing Address - Country:US
Mailing Address - Phone:646-221-7855
Mailing Address - Fax:
Practice Address - Street 1:974 BROADWAY
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1139
Practice Address - Country:US
Practice Address - Phone:914-769-0799
Practice Address - Fax:914-769-5011
Is Sole Proprietor?:No
Enumeration Date:2009-09-13
Last Update Date:2009-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0503641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice