Provider Demographics
NPI:1730238668
Name:WEISS, ERIC (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WEISS
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 1:340 E NORTHFIELD RD
Mailing Address - Street 2:SUITE #2A
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4892
Mailing Address - Country:US
Mailing Address - Phone:973-992-8600
Mailing Address - Fax:973-992-8626
Practice Address - Street 1:340 E NORTHFIELD RD
Practice Address - Street 2:SUITE #2A
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:973-992-8600
Practice Address - Fax:973-992-8626
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018072001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics