Provider Demographics
NPI:1386096618
Name:MARDER, YOSEF CHAIM (DMD)
Entity type:Individual
Prefix:DR
First Name:YOSEF
Middle Name:CHAIM
Last Name:MARDER
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 1:538 COLDSTREAM AVE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M6B 2K9
Mailing Address - Country:CA
Mailing Address - Phone:647-673-7863
Mailing Address - Fax:
Practice Address - Street 1:302 NW 179TH AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2818
Practice Address - Country:US
Practice Address - Phone:954-374-9215
Practice Address - Fax:954-589-0290
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD20403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist