Individual
DR. BLAKE ALAN WEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
982 KOEHLINGER DR, NEW HAVEN, IN 46774-1712
(260) 748-3696
Mailing address
4619 ABOITE LAKE DR, FORT WAYNE, IN 46804-4022
(260) 285-0858
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012948A
IN
Other
Enumeration date
05/08/2018
Last updated
07/28/2022
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