Provider Demographics
NPI:1093881757
Name:WEICHERT, HARTLEY GUY III (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARTLEY
Middle Name:GUY
Last Name:WEICHERT
Suffix:III
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 1:2760 ORO DAM BLVD E
Mailing Address - Street 2:SUITE B
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5117
Mailing Address - Country:US
Mailing Address - Phone:530-534-8180
Mailing Address - Fax:530-534-9012
Practice Address - Street 1:2760 ORO DAM BLVD E
Practice Address - Street 2:SUITE B
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5117
Practice Address - Country:US
Practice Address - Phone:530-534-8180
Practice Address - Fax:530-534-9012
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice