Provider Demographics
NPI:1689754053
Name:LIANG, WEI WEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:WEI
Middle Name:WEN
Last Name:LIANG
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 1:3168 FIRE RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-9662
Mailing Address - Country:US
Mailing Address - Phone:609-645-8838
Mailing Address - Fax:609-645-8840
Practice Address - Street 1:3168 FIRE RD
Practice Address - Street 2:SUITE #1
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-9662
Practice Address - Country:US
Practice Address - Phone:609-645-8838
Practice Address - Fax:609-645-8840
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020484001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice