Provider Demographics
NPI:1811091010
Name:WEINHANDL, BRENT LLOYD (DDS)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:LLOYD
Last Name:WEINHANDL
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 1:909 E COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2064
Mailing Address - Country:US
Mailing Address - Phone:307-234-6671
Mailing Address - Fax:307-237-6061
Practice Address - Street 1:909 E COLLINS DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2064
Practice Address - Country:US
Practice Address - Phone:307-234-6671
Practice Address - Fax:307-237-6061
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist