Organization
BRUCE A WEITZ DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A WEITZ DDS (PRESIDENT)
(440) 282-1396
Entity
Organization
Contact information
Practice address
1700 COOPER FOSTER PARK RD W, LORAIN, OH 44053-3679
(440) 282-1396
(440) 282-1396
Mailing address
1700 COOPER FOSTER PARK RD W, LORAIN, OH 44053-3679
(440) 282-1396
(440) 282-1396
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30016126
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0872908
MEDICARE
OH
Enumeration date
04/14/2008
Last updated
04/14/2008
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