Individual
JONATHAN DAVID WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
811 N LYNNDALE DR STE 1A, APPLETON, WI 54914-3085
(920) 450-4378
Mailing address
1435 N MCCARTHY RD APT 5, APPLETON, WI 54913-8285
(920) 450-4378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002696-15
WI
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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