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General NPI Number Information
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NPI Number | 1942349782
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Entity Type | Individual
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Provider Name | MARTIN WEINBERG D.M.D.,PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 1518 WALNUT ST SUITE1101
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3419
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Country | US
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Telephone | 215-732-0505
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Fax | 215-732-8744
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Provider Business Mailing Address
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Address Line | 401 OAKWYNNE DR
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2304
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Country | US
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Telephone | 610-649-4192
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 018880
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License Number State | PA
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