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NPI Code Detail

MEDICARE: DR. HOWARD JEROME MARTIN DMD

MEDICARE: DR. HOWARD JEROME MARTIN DMD
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
1122300000XDentist22DI01637700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205810835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOWARD JEROME MARTIN DMD
Provider Business Mailing Address
First Line : 95 MARTIN LUTHER KING JR DR
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-3025
Country : US
Telephone Number : 201-685-7395
Fax Number : 201-322-7003
Provider Business Practice Location Address
First Line : 95 MARTIN LUTHER KING JR DR
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-3025
Country : US
Telephone Number : 201-685-7395
Fax Number : 201-332-7003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 08/04/2016

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