Provider Demographics
NPI:1265168033
Name:KOFMAN, MARSHA SAAD (RDH, CPHDH)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:SAAD
Last Name:KOFMAN
Suffix:
Gender:F
Credentials:RDH, CPHDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HALLETTS WAY
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3542
Mailing Address - Country:US
Mailing Address - Phone:603-930-2709
Mailing Address - Fax:
Practice Address - Street 1:2 HALLETTS WAY
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-3542
Practice Address - Country:US
Practice Address - Phone:603-930-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01292124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist