Provider Demographics
NPI:1033375993
Name:WEIMER, MARC WARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:WARD
Last Name:WEIMER
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 1:212 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-1929
Mailing Address - Country:US
Mailing Address - Phone:814-938-5070
Mailing Address - Fax:
Practice Address - Street 1:212 PINE ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-1929
Practice Address - Country:US
Practice Address - Phone:814-938-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022641-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist