Provider Demographics
NPI:1053453571
Name:WEYMAN, THOMAS LEE (DMD PA)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:WEYMAN
Suffix:
Gender:M
Credentials:DMD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 RT 31 N
Mailing Address - Street 2:PO BOX 5314
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809
Mailing Address - Country:US
Mailing Address - Phone:908-507-5438
Mailing Address - Fax:908-735-6651
Practice Address - Street 1:1484 RT 31 N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-735-8188
Practice Address - Fax:908-735-6651
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1011778001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice