| Porter, Martin, Salman, P.a. | |
|
94 Brick Rd West Jersey Medical Plaza Ste. 100 Marlton NJ 08053-2179 | |
| (856) 596-9099 | |
| (856) 983-5946 |
| Full Name | Porter, Martin, Salman, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 94 Brick Rd, Marlton, New Jersey |
| Authorized Official Name and Position | Bradford J. Porter (PRESIDENT) |
| Authorized Official Contact | 8565969099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Porter, Martin, Salman, P.a. 94 Brick Rd West Jersey Medical Plaza Ste. 100 Marlton NJ 08053-2179 Ph: (856) 596-9099 | Porter, Martin, Salman, P.a. 94 Brick Rd West Jersey Medical Plaza Ste. 100 Marlton NJ 08053-2179 Ph: (856) 596-9099 |
| NPI Number | 1689628604 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 08/16/2016 |
| Medicare PECOS PAC ID | 0042256174 |
|---|---|
| Medicare Enrollment ID | O20050629000621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689628604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DI14482 (New Jersey) | Primary |
| Provider Name | Bradford J Porter |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619965407 PECOS PAC ID: 1153365473 Enrollment ID: I20050616000751 |
| Provider Name | Gene J Martin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366430159 PECOS PAC ID: 8921044066 Enrollment ID: I20050705000010 |
| Provider Name | James B Salman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326209958 PECOS PAC ID: 7113192840 Enrollment ID: I20130709000417 |
| Provider Name | Frank J Doroba |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639446834 PECOS PAC ID: 7911130109 Enrollment ID: I20151005000207 |
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