Provider Demographics
NPI:1295867299
Name:WEBER, WILLIAM LEWIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEWIS
Last Name:WEBER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3010
Mailing Address - Country:US
Mailing Address - Phone:864-282-1935
Mailing Address - Fax:864-282-1955
Practice Address - Street 1:216 S MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-2331
Practice Address - Country:US
Practice Address - Phone:864-427-0397
Practice Address - Fax:864-427-8286
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC-17751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice