Provider Demographics
NPI:1730243338
Name:WEISS, ARTHUR WILLIAM
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:WILLIAM
Last Name:WEISS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10553 RIVERSIDE DR.
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2440
Mailing Address - Country:US
Mailing Address - Phone:818-762-0694
Mailing Address - Fax:818-762-0661
Practice Address - Street 1:10553 RIVERSIDE DR.
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2440
Practice Address - Country:US
Practice Address - Phone:818-762-0694
Practice Address - Fax:818-762-0661
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice