Provider Demographics
NPI:1881600997
Name:WEISER, RICHARD S JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:WEISER
Suffix:JR
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 1:11925 PEARL RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3353
Mailing Address - Country:US
Mailing Address - Phone:440-238-1555
Mailing Address - Fax:440-238-7129
Practice Address - Street 1:11925 PEARL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3353
Practice Address - Country:US
Practice Address - Phone:440-238-1555
Practice Address - Fax:440-238-7129
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH195861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice