Provider Demographics
NPI:1659448991
Name:WEIDMAN, ALVIN FRANK JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:FRANK
Last Name:WEIDMAN
Suffix:JR
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:918 CHESTNUT RIDGE RD
Mailing Address - Street 2:SUITE #5
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2822
Mailing Address - Country:US
Mailing Address - Phone:304-598-2500
Mailing Address - Fax:304-598-2517
Practice Address - Street 1:918 CHESTNUT RIDGE RD
Practice Address - Street 2:SUITE #5
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2822
Practice Address - Country:US
Practice Address - Phone:304-598-2500
Practice Address - Fax:304-598-2517
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV27891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics