Provider Demographics
NPI:1487643789
Name:WEEKS, DONALD BENJAMIN
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BENJAMIN
Last Name:WEEKS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:B
Other - Last Name:WEEKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:149 DURHAM RD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2677
Mailing Address - Country:US
Mailing Address - Phone:203-245-6985
Mailing Address - Fax:
Practice Address - Street 1:149 DURHAM RD
Practice Address - Street 2:SUITE 32
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2677
Practice Address - Country:US
Practice Address - Phone:203-245-6985
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0054971223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics