Provider Demographics
NPI:1003033606
Name:WEISEL, STEVEN SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SCOTT
Last Name:WEISEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5209
Mailing Address - Country:US
Mailing Address - Phone:954-974-4300
Mailing Address - Fax:954-974-4563
Practice Address - Street 1:5404 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5209
Practice Address - Country:US
Practice Address - Phone:954-974-4300
Practice Address - Fax:954-974-4563
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN99261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice