Provider Demographics
NPI:1760550529
Name:WESTON, DONALD H (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:H
Last Name:WESTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 GARDEN STREET
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109
Mailing Address - Country:US
Mailing Address - Phone:860-529-2595
Mailing Address - Fax:860-529-5759
Practice Address - Street 1:75 GARDEN STREET
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109
Practice Address - Country:US
Practice Address - Phone:860-529-2595
Practice Address - Fax:860-529-5759
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT60691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice