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Organization
RANDALL L WEISEL, DDS, PA
Active
Organization
RANDALL L WEISEL, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL L WEISEL DDS (PRESIDENT)
(727) 536-5787
Entity
Organization
Contact information
Practice address
3700 E BAY DR, LARGO, FL 33771-1935
(727) 536-5787
(727) 530-9630
Mailing address
3700 E BAY DR, LARGO, FL 33771-1935
(727) 536-5787
(727) 530-9630
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN0010195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15140
FORTIS
FL
01
—
215754
CIGNA
FL
01
—
4010
COMPBENEFITS
FL
01
—
60453
BLUE CROSS BLUE SHIELD
FL
01
—
604999
UNITED CONCORDIA
FL
01
—
9676
SAFEGUARD
FL
Enumeration date
10/25/2006
Last updated
08/22/2020
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