Provider Demographics
NPI:1063431369
Name:JABLOW, MARTIN (DMD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:JABLOW
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 1:135 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2961
Mailing Address - Country:US
Mailing Address - Phone:732-636-3434
Mailing Address - Fax:732-636-7487
Practice Address - Street 1:135 GREEN ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2961
Practice Address - Country:US
Practice Address - Phone:732-636-3434
Practice Address - Fax:732-636-7487
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI157041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU37482Medicare UPIN