Individual
MR. GARY LOUIS WEITEKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2407 ST ANDREWS BLVD, SUITE A, PANAMA CITY, FL 32405-2170
(850) 763-5021
(850) 769-5025
Mailing address
2407 ST ANDREWS BLVD, SUITE A, PANAMA CITY, FL 32405-2170
(850) 763-5021
(850) 769-5025
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN0009503
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
547422
UNITED CONCORDIA INS CO
—
Enumeration date
05/08/2007
Last updated
07/08/2007
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