Provider Demographics
NPI:1285700419
Name:WEISER, PHILIP ALDEN (DDS)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ALDEN
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 1:5769 BONALY CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9439
Mailing Address - Country:US
Mailing Address - Phone:614-761-3233
Mailing Address - Fax:
Practice Address - Street 1:81 S 4TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4308
Practice Address - Country:US
Practice Address - Phone:614-224-1943
Practice Address - Fax:614-224-1965
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice