Provider Demographics
NPI:1730174418
Name:WEIBEL, DENNIS E (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:WEIBEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DENNIS
Other - Middle Name:E
Other - Last Name:WEIBEL
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:204 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-2123
Mailing Address - Country:US
Mailing Address - Phone:918-687-3321
Mailing Address - Fax:918-687-0422
Practice Address - Street 1:204 N 37TH ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2123
Practice Address - Country:US
Practice Address - Phone:918-687-3321
Practice Address - Fax:918-687-0422
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice