Provider Demographics
NPI:1205992104
Name:DEMARCO, WILLIAM J (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DEMARCO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TUCKERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-2805
Mailing Address - Country:US
Mailing Address - Phone:609-296-8700
Mailing Address - Fax:609-294-4770
Practice Address - Street 1:405 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:TUCKERTON
Practice Address - State:NJ
Practice Address - Zip Code:08087-2233
Practice Address - Country:US
Practice Address - Phone:609-296-8700
Practice Address - Fax:609-294-4770
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI21218122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist