Provider Demographics
NPI:1558153353
Name:WEIR, ANGELA KAY
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAY
Last Name:WEIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:SC
Mailing Address - Zip Code:29706-8568
Mailing Address - Country:US
Mailing Address - Phone:803-581-3555
Mailing Address - Fax:803-581-7924
Practice Address - Street 1:701 WILSON ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:SC
Practice Address - Zip Code:29706-8568
Practice Address - Country:US
Practice Address - Phone:803-581-3555
Practice Address - Fax:803-581-7924
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant