Provider Demographics
NPI:1962547836
Name:MARVIN LAGSTEIN D M D P A
Entity type:Organization
Organization Name:MARVIN LAGSTEIN D M D P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAGSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-337-6135
Mailing Address - Street 1:9 POST RD
Mailing Address - Street 2:SUITE M1A
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-1618
Mailing Address - Country:US
Mailing Address - Phone:201-337-6135
Mailing Address - Fax:201-337-8008
Practice Address - Street 1:9 POST ROAD
Practice Address - Street 2:SUITE M1A LONGHILL MEDICAL DENTAL CENTER
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436
Practice Address - Country:US
Practice Address - Phone:201-337-6135
Practice Address - Fax:201-337-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty