Provider Demographics
NPI:1740485564
Name:WESTON, ROBERT MORRIS (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MORRIS
Last Name:WESTON
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 1:123 KINDTS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-9157
Mailing Address - Country:US
Mailing Address - Phone:484-995-4151
Mailing Address - Fax:570-366-3894
Practice Address - Street 1:1439 CENTRE TPKE
Practice Address - Street 2:ROUTE 61
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9066
Practice Address - Country:US
Practice Address - Phone:570-366-1014
Practice Address - Fax:570-366-3894
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025988L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist