Provider Demographics
NPI:1043487648
Name:STEVEN D WEISSMAN DMD PA
Entity Type:Organization
Organization Name:STEVEN D WEISSMAN DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-864-1656
Mailing Address - Street 1:1031 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:33154
Mailing Address - Country:US
Mailing Address - Phone:305-864-1656
Mailing Address - Fax:305-861-2269
Practice Address - Street 1:1031 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:33154
Practice Address - Country:US
Practice Address - Phone:305-864-1656
Practice Address - Fax:305-861-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty