Individual
MICHAEL B WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14 SOUTH CEDAR ST, HAZLETON, PA 18201-6602
(570) 455-6275
(570) 455-6276
Mailing address
14 SOUTH CEDAR ST, HAZLETON, PA 18201-6602
(570) 455-6275
(570) 455-6276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS021559L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000769058
—
PA
01
—
0008010
DORAL DENTAL
—
01
—
137905
UNITED CONCORDIA
—
01
—
91848
UNISON HEALTH PLAN
—
Enumeration date
08/24/2006
Last updated
03/04/2013
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