| Doctor Name: | DR. JARED SCOTT WEINER |
| NPI Number: | 1598003121 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DMD |
| License Number: | DS040283 |
| Business Practice Address: | 1300 Bridgetown Pike Feasterville, PA - 190534326 |
| Business Phone Number: | 2153227810 |
| Business Fax Number: | 2153227832 |
| Mailing Address: | 1300 Bridgetown Pike, FEASTERVILLE |
| State: | PA |
| Postal Code: | 190534326 |
| Phone Number: | 2153227810 |
| Fax Number: | 2153227832 |
| NPI Enumeration Date: | 01/16/2013 |
| NPI Last Update Date: | 08/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | DS040283 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |