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Organization
JIMMIE LEE DENTAL LLC
Active
Organization
JIMMIE LEE DENTAL LLC
Active
Other names
Voorhees Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WIENER DMD (OWNER)
(856) 753-2900
Entity
Organization
Contact information
Practice address
180 ROUTE 73, SUITE 1202, VOORHEES, NJ 08043-9546
(856) 753-2900
(856) 753-5151
Mailing address
180 ROUTE 73, SUITE 1202, VOORHEES, NJ 08043-9546
(856) 753-2900
(856) 753-5151
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22DI01046700
NJ
1223G0001X
General Practice Dentistry
Primary
22DI02555100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0328651
—
NJ
05
—
0469947
—
NJ
Enumeration date
09/15/2016
Last updated
09/15/2016
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