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General NPI Number Information
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NPI Number | 1164687729
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Entity Type | Individual
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Provider Name | DANIEL KENNETH WEESE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 524 RED LANE RD SUITE F
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City | BIRMINGHAM
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State | AL
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Zip | 35215-8245
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Country | US
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Telephone | 205-836-4044
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Fax | 205-836-4311
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Provider Business Mailing Address
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Address Line | 2001 20TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35209-1343
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Country | US
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Telephone | 615-260-6067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5643
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License Number State | AL
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