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General NPI Number Information
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NPI Number | 1356403059
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Entity Type | Individual
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Provider Name | WAYNE MICHAEL DENTROUX D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 901 ROUTE 168 SUITE 405
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-3210
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Country | US
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Telephone | 856-374-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 173 COMMODORE RD
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-4826
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Country | US
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Telephone | 609-660-2058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MC04114
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License Number State | NJ
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