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General NPI Number Information
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NPI Number | 1053560847
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Entity Type | Organization
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Legal Business Name | DAVID WEINSTEIN
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 870 PALISADE AVE SUITE 303
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City | TEANECK
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State | NJ
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Zip | 07666-3419
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Country | US
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Telephone | 201-836-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 870 PALISADE AVE SUITE 303
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City | TEANECK
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State | NJ
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Zip | 07666-3419
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Country | US
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Telephone | 201-836-5200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID WEINSTEIN
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Credential | DMD
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Telephone | 201-836-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D1018602
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License Number State | NJ
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