Individual
SCOTT WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 BAY CLUB DR, APT. PHX, BAYSIDE, NY 11360-2915
(718) 597-3584
Mailing address
1 BAY CLUB DR, APT. PHX, BAYSIDE, NY 11360-2915
(718) 597-3584
(718) 597-6230
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
039629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01156321
—
NY
Enumeration date
05/23/2007
Last updated
07/09/2007
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