MEDICARE: DR. MARTEN N LADMAN D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	NJDI 14939	NJ

General Provider Information

NPI Number	:	1427055219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTEN N LADMAN D.M.D

Provider Business Mailing Address
First Line	:	87 COUNTY ROAD 520
Second Line	:
City	:	MORGANVILLE
State	:	NJ
Zip	:	07751-1241
Country	:	US
Telephone Number	:	732-972-0002
Fax Number	:	732-972-5636

Provider Business Practice Location Address
First Line	:	87 COUNTY ROAD 520
Second Line	:
City	:	MORGANVILLE
State	:	NJ
Zip	:	07751-1241
Country	:	US
Telephone Number	:	732-972-0002
Fax Number	:	732-972-5636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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