Organization
DR. KEVIN T WEITZEL DMD MS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN T WEITZEL DMD (OWNER)
(614) 876-4277
Entity
Organization
Contact information
Practice address
3535 FISHINGER BLVD, HILLIARD, OH 43026-7504
(614) 586-3994
Mailing address
3535 FISHINGER BLVD, HILLIARD, OH 43026-7504
(614) 586-3994
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30-022995
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3104992
—
OH
Enumeration date
04/11/2013
Last updated
04/11/2013
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