Individual
MICHAEL K WEISBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 MARINER WAY, MONSEY, NY 10952-1600
(845) 362-7645
(845) 354-1971
Mailing address
1 MARINER WAY, MONSEY, NY 10952-1600
(845) 362-7645
(845) 354-1971
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
049920
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DI 02213000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02351935
—
NY
Enumeration date
11/15/2006
Last updated
11/06/2012
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