Provider Demographics
NPI:1477691053
Name:MAYHER, VINCENT CLARK JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:CLARK
Last Name:MAYHER
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 1:300 N HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1723
Mailing Address - Country:US
Mailing Address - Phone:856-429-0404
Mailing Address - Fax:856-429-7605
Practice Address - Street 1:300 N HADDON AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1723
Practice Address - Country:US
Practice Address - Phone:856-429-0404
Practice Address - Fax:856-429-7605
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ117601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice