Provider Demographics
NPI:1881815066
Name:ADLER, IRA JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:JAY
Last Name:ADLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002A LINCOLN DRIVE WEST
Mailing Address - Street 2:GREENTREE EXECUTIVE CAMPUS
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-983-2002
Mailing Address - Fax:856-983-5680
Practice Address - Street 1:2002A LINCOLN DRIVE WEST
Practice Address - Street 2:GREENTREE EXECUTIVE CAMPUS
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-983-2002
Practice Address - Fax:856-983-5680
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011938001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice