Healthcare Provider Details

I. General information

NPI: 1003108101
Provider Name (Legal Business Name): DENNIS WILLIAM WEISEND R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 WALES RD NE
MASSILLON OH
44646-2302
US

IV. Provider business mailing address

1746 MOUNT PLEASANT ST NE
CANTON OH
44721-1350
US

V. Phone/Fax

Practice location:
  • Phone: 330-833-3194
  • Fax:
Mailing address:
  • Phone: 330-494-2327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03111121
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: