Organization
TIMOTHY D WEZEMAN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY D WEZEMAN DDS (OWNER)
(360) 679-1581
Entity
Organization
Contact information
Practice address
926 E WHIDBEY AVE, OAK HARBOR, WA 98277-2674
(360) 679-1581
(360) 679-4818
Mailing address
926 E WHIDBEY AVE, OAK HARBOR, WA 98277-2674
(360) 679-1581
(360) 679-4818
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4813
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4813
LICENSE
WA
Enumeration date
02/19/2009
Last updated
02/19/2009
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