Provider Demographics
NPI:1407249865
Name:ANDREW WEBER DMD MS PLLC
Entity Type:Organization
Organization Name:ANDREW WEBER DMD MS PLLC
Other - Org Name:EXCELLENT PERIODONTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-469-5603
Mailing Address - Street 1:4450 LOCKHILL SELMA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4394
Mailing Address - Country:US
Mailing Address - Phone:210-496-5603
Mailing Address - Fax:210-496-1286
Practice Address - Street 1:4450 LOCKHILL SELMA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4394
Practice Address - Country:US
Practice Address - Phone:210-496-5603
Practice Address - Fax:210-496-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty