Provider Demographics
NPI:1861557365
Name:WEIHER, DOUGLAS G (DDS)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:G
Last Name:WEIHER
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 1:13481 60TH ST N
Mailing Address - Street 2:
Mailing Address - City:OAK PARK HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55082-1055
Mailing Address - Country:US
Mailing Address - Phone:651-430-9990
Mailing Address - Fax:651-430-3448
Practice Address - Street 1:13481 60TH ST N
Practice Address - Street 2:
Practice Address - City:OAK PARK HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55082-1055
Practice Address - Country:US
Practice Address - Phone:651-430-9990
Practice Address - Fax:651-430-3448
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice