Individual
DR. GREGORY C. WEEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9825 GILES RD # AB, LA VISTA, NE 68128-2927
(402) 932-1177
Mailing address
9825 GILES RD # AB, LA VISTA, NE 68128-2927
(402) 932-1177
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6322
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7810
BCBS IDENTIFIER
NE
05
—
83034611500
—
NE
Enumeration date
05/08/2007
Last updated
06/14/2013
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