Provider Demographics
NPI:1548300627
Name:WEBER, ANDREW JOHN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:WEBER
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 LOCKHILL SELMA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4394
Mailing Address - Country:US
Mailing Address - Phone:210-496-5603
Mailing Address - Fax:210-496-1286
Practice Address - Street 1:4450 LOCKHILL SELMA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4394
Practice Address - Country:US
Practice Address - Phone:210-496-5603
Practice Address - Fax:210-496-1286
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0160671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics