Healthcare Provider Details

I. General information

NPI: 1154414399
Provider Name (Legal Business Name): SANTUCCI AND WEISS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S BROAD ST
TRENTON NJ
08611-1410
US

IV. Provider business mailing address

1100 S BROAD ST
TRENTON NJ
08611-1410
US

V. Phone/Fax

Practice location:
  • Phone: 609-393-6404
  • Fax: 609-393-6424
Mailing address:
  • Phone: 609-393-6404
  • Fax: 609-393-6424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN J SANTUCCI
Title or Position: SECRETARY
Credential: D.D.S.
Phone: 609-393-6404