Provider Demographics
NPI:1154414399
Name:SANTUCCI AND WEISS, PA
Entity type:Organization
Organization Name:SANTUCCI AND WEISS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-393-6404
Mailing Address - Street 1:1100 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1410
Mailing Address - Country:US
Mailing Address - Phone:609-393-6404
Mailing Address - Fax:609-393-6424
Practice Address - Street 1:1100 S BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1410
Practice Address - Country:US
Practice Address - Phone:609-393-6404
Practice Address - Fax:609-393-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty