Individual
JAI VAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1751 WILMINGTON PIKE, STE F-2, GLEN MILLS, PA 19342
(484) 309-5055
Mailing address
6437 E PACIFIC COAST HWY UNIT A-6, LONG BEACH, CA 90803-4201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
108880
CA
122300000X
Dentist
Primary
DS044011
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2022
Last updated
10/15/2024
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