Provider Demographics
NPI:1265647994
Name:WEYMAN, PAUL S
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:S
Last Name:WEYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 S CLARKSON
Mailing Address - Street 2:# 310
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113
Mailing Address - Country:US
Mailing Address - Phone:303-762-8048
Mailing Address - Fax:303-762-8034
Practice Address - Street 1:3601 S CLARKSON
Practice Address - Street 2:# 310
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113
Practice Address - Country:US
Practice Address - Phone:303-762-8048
Practice Address - Fax:303-762-8034
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist