Provider Demographics
NPI:1164813218
Name:VANE, EUGENE F JR (DMD)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:F
Last Name:VANE
Suffix:JR
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:WHITTLESEY ROAD & STUYVESANT AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08625
Mailing Address - Country:US
Mailing Address - Phone:609-292-4036
Mailing Address - Fax:609-943-5449
Practice Address - Street 1:168 FRONTAGE ROAD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114
Practice Address - Country:US
Practice Address - Phone:973-465-0068
Practice Address - Fax:973-466-0234
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010862001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice