Organization
MICHAEL WEISS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B WEISS DDS (PRESIDENT)
(570) 455-6275
Entity
Organization
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006799
DORAL DENTAL
—
01
—
68403
UNISON HEALTH PLAN
—
01
—
971440
UNITED CONCORDIA
—
Enumeration date
08/24/2006
Last updated
08/22/2020
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