Provider Demographics
NPI:1659591089
Name:WEISBARD, LEE AMY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:AMY
Last Name:WEISBARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 E BELLEVIEW AVE SUITE 280
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-773-3373
Mailing Address - Fax:303-773-3380
Practice Address - Street 1:7901 E BELLEVIEW AVE STE 280
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6059
Practice Address - Country:US
Practice Address - Phone:303-773-3373
Practice Address - Fax:303-773-3380
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105744122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist