Provider Demographics
NPI:1083798581
Name:WEINER, ROBERT E (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:WEINER
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 1:182 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3516
Mailing Address - Country:US
Mailing Address - Phone:609-924-1234
Mailing Address - Fax:609-497-1518
Practice Address - Street 1:182 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3516
Practice Address - Country:US
Practice Address - Phone:609-924-1234
Practice Address - Fax:609-497-1518
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0121421223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics