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NPI 1124595681

NPI 1124595681 : JAY WEINBERG, DMD., PA : CRANFORD, NJ

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General NPI Number Information
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    NPI Number           |    1124595681
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    Entity Type          |    Organization 
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    Legal Business Name  |    JAY WEINBERG, DMD., PA 
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Dates
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    Enumeration Date     |    11/01/2018
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    Last Update Date     |    11/06/2018
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Provider Practice Location Address
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    Address Line         |    300 NORTH AVE E 
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    City                 |    CRANFORD
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    State                |    NJ
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    Zip                  |    07016-2435
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    Country              |    US
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    Telephone            |    908-276-7773
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    Fax                  |    908-276-5522
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Provider Business Mailing Address
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    Address Line         |    300 NORTH AVE E 
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    City                 |    CRANFORD
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    State                |    NJ
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    Zip                  |    07016-2435
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    Country              |    US
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    Telephone            |    908-276-7773
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    Fax                  |    908-276-5522
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. JAY  WEINBERG 
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    Credential           |    DMD
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    Telephone            |    908-276-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223E0200X
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    Taxonomy Name        |    Endodontics
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    License Number       |    
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    License Number State |    
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