MEDICARE: ALLAN D WEIMER DDS MS PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	00300	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710916606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLAN D WEIMER DDS MS PC

Provider Business Mailing Address
First Line	:	100 PARK AVE
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-5012
Country	:	US
Telephone Number	:	970-879-4290
Fax Number	:	970-879-6481

Provider Business Practice Location Address
First Line	:	100 PARK AVE
Second Line	:
City	:	STEAMBOAT SPRINGS
State	:	CO
Zip	:	80487-5012
Country	:	US
Telephone Number	:	970-879-4290
Fax Number	:	970-879-6481

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. ALLAN D WEIMER
Credential	:	DDS MS
Telephone Number	:	970-879-4290

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	08/22/2020

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