Individual
MARK I BIRNBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3 THIRD STREET, SUITE 101, BORDERTOWN, NJ 08505-1321
(609) 298-1964
(609) 298-8443
Mailing address
3 THIRD STREET, SUITE 101, BORDERTOWN, NJ 08505-1321
(609) 298-1964
(609) 298-8443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI018752
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00864
UNITED CONCORDIA
PA
01
—
22189
DELTA DENTAL
NJ
01
—
99999
BLUE CROSS
—
Enumeration date
08/30/2006
Last updated
07/08/2007
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