MEDICARE: DR. STEVEN SCOTT WEISEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN9926	FL

General Provider Information

NPI Number	:	1003033606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN SCOTT WEISEL DDS

Provider Business Mailing Address
First Line	:	5404 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5209
Country	:	US
Telephone Number	:	954-974-4300
Fax Number	:	954-974-4563

Provider Business Practice Location Address
First Line	:	5404 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5209
Country	:	US
Telephone Number	:	954-974-4300
Fax Number	:	954-974-4563

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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