Provider Demographics
NPI:1215745203
Name:MARC NARDEA DMD PLLC
Entity type:Organization
Organization Name:MARC NARDEA DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PEDIATRIC DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:NARDEA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-309-4845
Mailing Address - Street 1:347 5TH AVE RM 1210
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5025
Mailing Address - Country:US
Mailing Address - Phone:908-309-4845
Mailing Address - Fax:
Practice Address - Street 1:347 5TH AVE RM 1210
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5025
Practice Address - Country:US
Practice Address - Phone:908-309-4845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty