Individual
DR. JENNIFER ANN WEYDERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8980 HUDSON BLVD N, LAKE ELMO, MN 55042-9704
(651) 735-9057
(651) 501-1471
Mailing address
2900 THOMAS AVE S, APT 1907, MINNEAPOLIS, MN 55416-4477
(612) 929-2590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12179
MN
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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