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General NPI Number Information
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NPI Number | 1073181939
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Entity Type | Individual
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Provider Name | JENNIFER AUDREY MARTIN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 485 AMWELL RD
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-8213
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Country | US
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Telephone | 908-359-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 443 S WOODS RD
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-3128
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Country | US
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Telephone | 973-879-4893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS043167
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02844600
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License Number State | NJ
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