Provider Demographics
NPI:1184725418
Name:TERZIS, MICHAEL JAY JR (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAY
Last Name:TERZIS
Suffix:JR
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:M
Other - Middle Name:JAY
Other - Last Name:TERZIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MSD PA
Mailing Address - Street 1:8 SHUNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940
Mailing Address - Country:US
Mailing Address - Phone:973-377-0900
Mailing Address - Fax:973-377-4441
Practice Address - Street 1:8 SHUNPIKE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940
Practice Address - Country:US
Practice Address - Phone:973-377-0900
Practice Address - Fax:973-377-4441
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005627122300000X
NJ96511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics