Provider Demographics
NPI:1972697076
Name:MARZARELLA, JENNIFER (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MARZARELLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FOXFIRE LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-2001
Mailing Address - Country:US
Mailing Address - Phone:908-238-0659
Mailing Address - Fax:
Practice Address - Street 1:168 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2324
Practice Address - Country:US
Practice Address - Phone:908-852-6611
Practice Address - Fax:908-852-5236
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020848001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice