| Irena Jug-weiss,d.m.d.,l.l.c. | |
|
115 E Main St Maple Shade NJ 08052-2621 | |
| (856) 779-7450 | |
| (856) 779-7702 |
| Full Name | Irena Jug-weiss,d.m.d.,l.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 115 E Main St, Maple Shade, New Jersey |
| Authorized Official Name and Position | Irena Jug-weiss (DENTIST PROPRIETOR) |
| Authorized Official Contact | 8567797450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irena Jug-weiss,d.m.d.,l.l.c. 115 E Main St Maple Shade NJ 08052-2621 Ph: (856) 779-7450 | Irena Jug-weiss,d.m.d.,l.l.c. 115 E Main St Maple Shade NJ 08052-2621 Ph: (856) 779-7450 |
| NPI Number | 1073723888 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073723888 | NPI | - | NPPES |
| DI0162910 | Other | NJ | STATE DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DI016291 (New Jersey) | Primary |