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General NPI Number Information
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NPI Number | 1790872042
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Entity Type | Individual
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Provider Name | JEFFREY A WEISS DMD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15600 NW 67 AVE #110
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City | MIAMI LAKES
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State | FL
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Zip | 33014
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Country | US
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Telephone | 305-823-8831
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Fax |
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Provider Business Mailing Address
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Address Line | 15102 SW 38TH ST
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City | DAVIE
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State | FL
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Zip | 33331
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Country | US
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Telephone | 954-236-0067
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN15340
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License Number State | FL
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