Provider Demographics
NPI:1801030200
Name:WEILAND, ANGELA M (DH)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:M
Last Name:WEILAND
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S COLBY ST
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-2808
Mailing Address - Country:US
Mailing Address - Phone:515-395-3993
Mailing Address - Fax:
Practice Address - Street 1:109 S COLBY ST
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-2808
Practice Address - Country:US
Practice Address - Phone:515-395-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03441124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist