Healthcare Provider Details

I. General information

NPI: 1750255758
Provider Name (Legal Business Name): ROSS M WEZMAR DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 N FIFTH STREET HWY SUITE B
READING PA
19605
US

IV. Provider business mailing address

2230 N FIFTH STREET HWY SUITE B
READING PA
19605
US

V. Phone/Fax

Practice location:
  • Phone: 610-631-4121
  • Fax:
Mailing address:
  • Phone: 610-631-4121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL SKOLNICK
Title or Position: OWNER
Credential: DMD
Phone: 908-469-9100