Provider Demographics
NPI:1700084001
Name:ASEN, JEFFREY MARC (DDS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MARC
Last Name:ASEN
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 1:3322 US HIGHWAY 22
Mailing Address - Street 2:SUITE 503
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3476
Mailing Address - Country:US
Mailing Address - Phone:908-595-1000
Mailing Address - Fax:908-595-0600
Practice Address - Street 1:3322 US HIGHWAY 22
Practice Address - Street 2:SUITE 503
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3476
Practice Address - Country:US
Practice Address - Phone:908-595-1000
Practice Address - Fax:908-595-0600
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 11927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDI 11927OtherDENTAL LICENSE NUMBER