Provider Demographics
NPI:1154387405
Name:WEINER, SAUL (DDS)
Entity type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BERGEN STREET
Mailing Address - Street 2:NEW JERSEY DENTAL SCHOOL ROOM D830
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101
Mailing Address - Country:US
Mailing Address - Phone:973-972-4615
Mailing Address - Fax:973-972-0370
Practice Address - Street 1:110 BERGEN STREET SUITE 7700
Practice Address - Street 2:CENTER DENTAL ORAL HEALTH DOCTORS OFFICE CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07101
Practice Address - Country:US
Practice Address - Phone:973-972-2444
Practice Address - Fax:973-972-2441
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD5102501223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics