Provider Demographics
NPI:1831117712
Name:WEIBERT, RICHARD JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:WEIBERT
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 1:6 MCBRIDE AND SON CENTER DR
Mailing Address - Street 2:STE 203
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1418
Mailing Address - Country:US
Mailing Address - Phone:636-728-1199
Mailing Address - Fax:636-728-1198
Practice Address - Street 1:6 MCBRIDE AND SON CENTER DR
Practice Address - Street 2:STE 203
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1418
Practice Address - Country:US
Practice Address - Phone:636-728-1199
Practice Address - Fax:636-728-1198
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0153351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics