Provider Demographics
NPI:1730113267
Name:PINTER, MARK EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:PINTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:EDWARD
Other - Last Name:PINTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:105 EVESBORO MEDFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3865
Mailing Address - Country:US
Mailing Address - Phone:856-985-0330
Mailing Address - Fax:856-988-7283
Practice Address - Street 1:105 EVESBORO MEDFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3865
Practice Address - Country:US
Practice Address - Phone:856-985-0330
Practice Address - Fax:856-988-7283
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ130521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222726523OtherTIN/EIN