Provider Demographics
NPI:1730149303
Name:VECERE, JEFFREY W (DMD MSD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:W
Last Name:VECERE
Suffix:
Gender:M
Credentials:DMD MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210
Mailing Address - Country:US
Mailing Address - Phone:609-465-5175
Mailing Address - Fax:609-465-4657
Practice Address - Street 1:22 W PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210
Practice Address - Country:US
Practice Address - Phone:609-465-5175
Practice Address - Fax:609-465-4657
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ124961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1066576Medicaid
NJ1066576Medicaid
U80281Medicare UPIN