Provider Demographics
NPI:1811963218
Name:MERZEAU, HUMBERTO ANGEL (DDS, FAGD,PA)
Entity type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:ANGEL
Last Name:MERZEAU
Suffix:
Gender:M
Credentials:DDS, FAGD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 MAIN ST APT C
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5164
Mailing Address - Country:US
Mailing Address - Phone:201-342-5929
Mailing Address - Fax:201-342-9208
Practice Address - Street 1:953-C MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5103
Practice Address - Country:US
Practice Address - Phone:201-342-5929
Practice Address - Fax:201-342-9208
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13490122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist