Individual
DR. OTILIA MARTICORENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
768 NEWARK AVE, ELIZABETH, NJ 07208-3536
(908) 355-8555
(908) 355-8590
Mailing address
768 NEWARK AVE, ELIZABETH, NJ 07208-3536
(908) 355-8555
(908) 355-8590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01915100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7573201
—
NJ
Enumeration date
01/15/2007
Last updated
07/09/2007
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