Weitz, Dustin Frederick

Weitz, Dustin Frederick is an individual health care provider with primary practice located at 505 S Mountain View Rd Ste 4 , Moscow ID 83843-9205. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Weitz, Dustin Frederick can be contacted via phone (208) 882-2986.

Contact Information

Primary practice address
505 S Mountain View Rd Ste 4 Moscow ID 83843-9205
Phone: (208) 882-2986
Fax: (208) 882-2987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D13926 Minnesota
Dental Providers / Endodontics 1223E0200X D-3556-EN Idaho

Profile Details

NPI number 1952429946
LBN Legal business name Weitz, Dustin Frederick
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Oct 3rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952429946 NPPES
Idaho MEDICAID 806107300

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