Provider Demographics
NPI:1487876165
Name:IRA J. ADLER DDS PC
Entity type:Organization
Organization Name:IRA J. ADLER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-983-2002
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011938001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty