Provider Demographics
NPI:1427357003
Name:WEBER, JESSICA MORGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MORGAN
Last Name:WEBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:MORGAN
Other - Last Name:MCGRATTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:510 S ROSE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3756
Mailing Address - Country:US
Mailing Address - Phone:410-706-2940
Mailing Address - Fax:
Practice Address - Street 1:8890 MCDONOGH RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4824
Practice Address - Country:US
Practice Address - Phone:410-697-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14785122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist