Provider Demographics
NPI:1558458778
Name:JEFFREY W VECERE DMD MSD PA
Entity Type:Organization
Organization Name:JEFFREY W VECERE DMD MSD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VECERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-465-5175
Mailing Address - Street 1:22 W PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2311
Mailing Address - Country:US
Mailing Address - Phone:609-465-5175
Mailing Address - Fax:
Practice Address - Street 1:22 W PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2311
Practice Address - Country:US
Practice Address - Phone:609-465-5175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1066576Medicaid
U80281Medicare UPIN