Provider Demographics
NPI:1427264852
Name:EVERITT, JEFFREY ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:EVERITT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3321
Mailing Address - Country:US
Mailing Address - Phone:973-984-6227
Mailing Address - Fax:
Practice Address - Street 1:625 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2233
Practice Address - Country:US
Practice Address - Phone:732-382-0500
Practice Address - Fax:732-382-0603
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice