Provider Demographics
NPI:1801913470
Name:WEINTRAUB, ROBERT A (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:WEINTRAUB
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 1:2839 STATE ROUTE 10
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1200
Mailing Address - Country:US
Mailing Address - Phone:973-644-0088
Mailing Address - Fax:973-644-0078
Practice Address - Street 1:2839 STATE ROUTE 10
Practice Address - Street 2:SUITE 201
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-1200
Practice Address - Country:US
Practice Address - Phone:973-644-0088
Practice Address - Fax:973-644-0078
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010041001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice