Provider Demographics
NPI:1821168469
Name:WEIGAND, JAMES FREDERICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FREDERICK
Last Name:WEIGAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BEECH HILL RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-8827
Mailing Address - Country:US
Mailing Address - Phone:207-777-7016
Mailing Address - Fax:
Practice Address - Street 1:364 MAINE ST
Practice Address - Street 2:
Practice Address - City:POLAND SPRING
Practice Address - State:ME
Practice Address - Zip Code:04274-5109
Practice Address - Country:US
Practice Address - Phone:207-998-4587
Practice Address - Fax:207-998-5354
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME35181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice