Organization
IRENA JUG-WEISS,D.M.D.,L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENA JUG-WEISS D.M.D. (DENTIST PROPRIETOR)
(856) 779-7450
Entity
Organization
Contact information
Practice address
115 E MAIN ST, MAPLE SHADE, NJ 08052-2621
(856) 779-7450
(856) 779-7702
Mailing address
115 E MAIN ST, MAPLE SHADE, NJ 08052-2621
(856) 779-7450
(856) 779-7702
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI016291
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI0162910
STATE DENTAL LICENSE
NJ
Enumeration date
05/23/2007
Last updated
08/02/2007
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