Provider Demographics
NPI:1649564840
Name:DANIEL A. WELDON, DMD, PLLC
Entity Type:Organization
Organization Name:DANIEL A. WELDON, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WELDON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-622-3236
Mailing Address - Street 1:812 NE 25TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6379
Mailing Address - Country:US
Mailing Address - Phone:352-622-3236
Mailing Address - Fax:352-622-9400
Practice Address - Street 1:812 NE 25TH AVE STE B
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6379
Practice Address - Country:US
Practice Address - Phone:352-622-3236
Practice Address - Fax:352-622-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN184421223G0001X
FLDN62911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty