Provider Demographics
NPI:1962520486
Name:PIKE, JEFFREY WITTER (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WITTER
Last Name:PIKE
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:PO BOX 635
Mailing Address - Street 2:27 HIGHWAY 202
Mailing Address - City:FAR HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07931-0635
Mailing Address - Country:US
Mailing Address - Phone:908-234-0800
Mailing Address - Fax:908-781-5731
Practice Address - Street 1:27 HIGHWAY 202
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FAR HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07931-0635
Practice Address - Country:US
Practice Address - Phone:908-234-0800
Practice Address - Fax:908-718-5731
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011987001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice