Individual
DR. DEREK WIDMAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
769 NORTHFIELD AVE, SUITE 154, WEST ORANGE, NJ 07052-1198
(973) 736-0111
(973) 325-3442
Mailing address
769 NORTHFIELD AVE, SUITE 154, WEST ORANGE, NJ 07052-1198
(973) 736-0111
(973) 325-3442
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21260
NJ
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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