Provider Demographics
NPI:1841868601
Name:SANTO, MARCUS (DMD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:
Last Name:SANTO
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 1:25 MEADOW AVE UNIT 79
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750-1036
Mailing Address - Country:US
Mailing Address - Phone:732-546-2816
Mailing Address - Fax:
Practice Address - Street 1:210 W FRONT ST STE 202
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1171
Practice Address - Country:US
Practice Address - Phone:732-530-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02890000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty