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General NPI Number Information
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NPI Number | 1194709410
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Entity Type | Organization
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Legal Business Name | LAWRENCE J WEISS DDS PC
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3131 LAWSON BLVD
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City | OCEANSIDE
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State | NY
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Zip | 11572-3717
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Country | US
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Telephone | 516-764-3062
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Fax | 516-764-0266
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Provider Business Mailing Address
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Address Line | 3131 LAWSON BLVD
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City | OCEANSIDE
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State | NY
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Zip | 11572-3717
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Country | US
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Telephone | 516-764-3062
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Fax | 516-764-0266
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. LAWRENCE J WEISS
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Credential | DDS
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Telephone | 516-764-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 043555
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License Number State | NY
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