Provider Demographics
NPI:1326393703
Name:WEISER, JEFFREY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:WEISER
Suffix:
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 1:7948 ROCKPORT CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7314
Mailing Address - Country:US
Mailing Address - Phone:561-965-8234
Mailing Address - Fax:
Practice Address - Street 1:1454 CAMPBELL RD
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4604
Practice Address - Country:US
Practice Address - Phone:713-722-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist