Provider Demographics
NPI:1184710238
Name:WEIMER, JAMES VANCE (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:VANCE
Last Name:WEIMER
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 1:115 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:MASONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15461
Mailing Address - Country:US
Mailing Address - Phone:724-583-9075
Mailing Address - Fax:724-583-9788
Practice Address - Street 1:115 N WATER ST
Practice Address - Street 2:
Practice Address - City:MASONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15461
Practice Address - Country:US
Practice Address - Phone:724-583-9075
Practice Address - Fax:724-583-9788
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021706L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist