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General NPI Number Information
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NPI Number | 1841868601
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Entity Type | Individual
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Provider Name | MARCUS SANTO DMD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 210 W FRONT ST STE 202
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City | RED BANK
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State | NJ
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Zip | 07701-1171
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Country | US
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Telephone | 732-530-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MEADOW AVE UNIT 79
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City | MONMOUTH BEACH
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State | NJ
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Zip | 07750-1036
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Country | US
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Telephone | 732-546-2816
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02890000
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License Number State | NJ
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