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General NPI Number Information
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NPI Number | 1861550634
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Entity Type | Organization
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Legal Business Name | EDWARD J. WEISBERG, D.D.S. & ASSOCIATES PC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 801 W LITTLE CREEK RD SUITE 103
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City | NORFOLK
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State | VA
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Zip | 23505-2036
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Country | US
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Telephone | 757-440-0044
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Fax | 757-440-0092
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Provider Business Mailing Address
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Address Line | 801 W LITTLE CREEK RD SUITE 103
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City | NORFOLK
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State | VA
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Zip | 23505-2036
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Country | US
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Telephone | 757-440-0044
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Fax | 757-440-0092
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD JOSEPH WEISBERG
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Credential | D.S.S.
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Telephone | 757-440-0044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4515
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License Number State | VA
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