Provider Demographics
NPI:1871564690
Name:ZWEBER, TERRI R (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:R
Last Name:ZWEBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5514
Mailing Address - Country:US
Mailing Address - Phone:360-734-6300
Mailing Address - Fax:360-734-6900
Practice Address - Street 1:4145 MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5514
Practice Address - Country:US
Practice Address - Phone:360-734-6300
Practice Address - Fax:360-734-6900
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000093501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5045224Medicaid