Provider Demographics
NPI:1801806518
Name:WEBER, DENNIS J II (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:WEBER
Suffix:II
Gender:M
Credentials:DMD, MS
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Other - Middle Name:
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Mailing Address - Street 1:1605 COUNTY ROAD 220 STE 110
Mailing Address - Street 2:ATTN DR. WEBER--ORTHODONTICS
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4909
Mailing Address - Country:US
Mailing Address - Phone:904-215-3533
Mailing Address - Fax:
Practice Address - Street 1:1605 COUNTY ROAD 220 STE 110
Practice Address - Street 2:ATTN DR. WEBER--ORTHODONTICS
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4909
Practice Address - Country:US
Practice Address - Phone:904-215-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN171981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics