Provider Demographics
NPI:1316052970
Name:NAGEL, MARTIN RICHARD
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:RICHARD
Last Name:NAGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3358
Mailing Address - Country:US
Mailing Address - Phone:732-249-4800
Mailing Address - Fax:
Practice Address - Street 1:529 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3358
Practice Address - Country:US
Practice Address - Phone:732-249-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101902001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice