Provider Demographics
NPI:1518222462
Name:WESTON, NEIL BRIAN STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BRIAN STUART
Last Name:WESTON
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 1:1468 HARBERT AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-4903
Mailing Address - Country:US
Mailing Address - Phone:901-484-6796
Mailing Address - Fax:
Practice Address - Street 1:7500 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3849
Practice Address - Country:US
Practice Address - Phone:901-754-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9524122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist