Provider Demographics
NPI:1285703140
Name:WEINBERGER, ALLEN MARSHALL (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:MARSHALL
Last Name:WEINBERGER
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 1:441 S LIVERNOIS
Mailing Address - Street 2:SUITE #165
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-651-0730
Mailing Address - Fax:248-651-0585
Practice Address - Street 1:441 S LIVERNOIS
Practice Address - Street 2:SUITE #165
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-651-0730
Practice Address - Fax:248-651-0585
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI112071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice