Provider Demographics
NPI:1578699088
Name:WEIR, YVETTE (DDS)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:WEIR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:
Other - Last Name:WEIR GLADSTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8630 FENTON STREET
Mailing Address - Street 2:1204
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:240-839-5811
Mailing Address - Fax:301-495-0318
Practice Address - Street 1:8630 FENTON STREET
Practice Address - Street 2:1204
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:240-839-5811
Practice Address - Fax:301-495-0318
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11178122300000X
MD16975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist