Provider Demographics
NPI:1275964306
Name:WEISSMAN, STEVEN DANIEL (DMD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DANIEL
Last Name:WEISSMAN
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 1:1031 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:33154
Mailing Address - Country:US
Mailing Address - Phone:305-864-1656
Mailing Address - Fax:305-861-2269
Practice Address - Street 1:1031 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:33154
Practice Address - Country:US
Practice Address - Phone:305-864-1656
Practice Address - Fax:305-861-2269
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice