Individual
DR. BRUCE WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
594 E MAIN ST, MIDDLETOWN, NY 10940-2632
(845) 342-2125
Mailing address
594 E MAIN ST, MIDDLETOWN, NY 10940-2632
(845) 342-2125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
036147
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036147
STATE LICENSE
NY
Enumeration date
09/14/2006
Last updated
07/08/2007
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