Individual
CYNTHIA L WEIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7916 PEBBLE BEACH DR, SUITE 101, CITRUS HEIGHTS, CA 95610-7790
(916) 962-0577
(916) 962-0584
Mailing address
7916 PEBBLE BEACH DR, SUITE 101, CITRUS HEIGHTS, CA 95610-7790
(916) 962-0577
(916) 962-0584
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
37753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
528432
UNITED CONCORDIA
CA
Enumeration date
08/16/2005
Last updated
07/08/2007
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