Provider Demographics
NPI:1215951454
Name:WEISER, ROBERT HAMILTON (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HAMILTON
Last Name:WEISER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14431 RINCON RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-5792
Mailing Address - Country:US
Mailing Address - Phone:760-242-5016
Mailing Address - Fax:760-946-2800
Practice Address - Street 1:16192 SISKIYOU RD
Practice Address - Street 2:STE 2
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1316
Practice Address - Country:US
Practice Address - Phone:760-946-2500
Practice Address - Fax:760-946-2800
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice