Provider Demographics
NPI:1871714964
Name:WEISS, RAYMOND B (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:B
Last Name:WEISS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CENTRAL PK AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3003
Mailing Address - Country:US
Mailing Address - Phone:914-472-4343
Mailing Address - Fax:914-472-7005
Practice Address - Street 1:800 CENTRAL PK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3003
Practice Address - Country:US
Practice Address - Phone:914-472-4343
Practice Address - Fax:914-472-7005
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY42752122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist