Provider Demographics
NPI:1477570133
Name:MENSH, MARK HARRISON (DMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:HARRISON
Last Name:MENSH
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 1:5429 HARDING HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2263
Mailing Address - Country:US
Mailing Address - Phone:609-625-0505
Mailing Address - Fax:609-625-8002
Practice Address - Street 1:5429 HARDING HWY STE 101
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2263
Practice Address - Country:US
Practice Address - Phone:609-625-0505
Practice Address - Fax:609-625-8002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019632021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice