Provider Demographics
NPI:1275528028
Name:WEICHEL, ERWIN (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:
Last Name:WEICHEL
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 SW SCHAEFFER RD
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-9661
Mailing Address - Country:US
Mailing Address - Phone:503-654-5405
Mailing Address - Fax:503-654-5406
Practice Address - Street 1:2636 SE HARRISON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7533
Practice Address - Country:US
Practice Address - Phone:503-654-5405
Practice Address - Fax:503-654-5406
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD53691223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics