| NPI | 1235056995 |
|---|---|
| Other Name | JACK WEBER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2026029689) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2026029689) |
| Enumeration Date | 2026-07-02 |
| Last Update Date | 2026-07-02 |