Provider Demographics
NPI:1982618153
Name:WEISENSEEL, JOHN ANTHONY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:WEISENSEEL
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1620 CRESPO DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-3844
Mailing Address - Country:US
Mailing Address - Phone:858-454-0675
Mailing Address - Fax:858-454-0675
Practice Address - Street 1:2655 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1633
Practice Address - Country:US
Practice Address - Phone:619-282-7088
Practice Address - Fax:619-297-0504
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA387691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics