Individual
MARK HENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
67 NJ-36, WEST LONG BRANCH, NJ 07764
(732) 771-7734
Mailing address
10 WHITTIER DR, MANALAPAN, NJ 07726-3720
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D102976600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2022
Last updated
08/02/2024
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