Provider Demographics
NPI:1467440461
Name:WEINER, RALPH H (DDS)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:H
Last Name:WEINER
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 1:2014 S TOLLGATE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5903
Mailing Address - Country:US
Mailing Address - Phone:410-515-2020
Mailing Address - Fax:410-515-2021
Practice Address - Street 1:2014 S TOLLGATE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5903
Practice Address - Country:US
Practice Address - Phone:410-515-2020
Practice Address - Fax:410-515-2021
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist