Healthcare Provider Details

I. General information

NPI: 1982778767
Provider Name (Legal Business Name): ARTHUR WEINBERG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 BROADWAY
WOODCLIFF LAKE NJ
07677-8005
US

IV. Provider business mailing address

104 BROADWAY
WOODCLIFF LAKE NJ
07677-8005
US

V. Phone/Fax

Practice location:
  • Phone: 201-307-1919
  • Fax: 201-307-8741
Mailing address:
  • Phone: 201-307-1919
  • Fax: 201-307-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number11084
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: