1104912559 NPI number — DR. DAVID CHRISTOPHER WEIGLE DMD

Table of content: DR. DAVID CHRISTOPHER WEIGLE DMD (NPI 1104912559)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104912559 NPI number — DR. DAVID CHRISTOPHER WEIGLE DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEIGLE
Provider First Name:
DAVID
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104912559
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 HERITAGE DR
Provider Second Line Business Mailing Address:
SUITE 811
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19464-9220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-327-1616
Provider Business Mailing Address Fax Number:
610-327-1617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 HERITAGE DR
Provider Second Line Business Practice Location Address:
SUITE 811
Provider Business Practice Location Address City Name:
POTTSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19464-9220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-327-1616
Provider Business Practice Location Address Fax Number:
610-327-1617
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DS027862L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com