Provider Demographics
NPI:1215477336
Name:WEISS AND TOR ORTHODONTICS, LLC
Entity type:Organization
Organization Name:WEISS AND TOR ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MPH
Authorized Official - Phone:440-885-1980
Mailing Address - Street 1:3755 ORANGE PL STE 100A
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4426
Mailing Address - Country:US
Mailing Address - Phone:216-292-6340
Mailing Address - Fax:
Practice Address - Street 1:3755 ORANGE PL STE 100A
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4426
Practice Address - Country:US
Practice Address - Phone:216-292-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0241551223X0400X
OH30-0168081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty