Individual
DR. MARK DEFONTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
59 BEAVERBROOK RD, SUITE 301, LINCOLN PARK, NJ 07035-1794
(973) 686-0060
(973) 686-0770
Mailing address
59 BEAVERBROOK RD, SUITE 301, LINCOLN PARK, NJ 07035-1794
(973) 686-0060
(973) 686-0770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17918
NJ
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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