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Provider Information for 1225124522



DR. GEORGE CALVIN WEBER DDS

Gender: MALE

Individual NPI: 1225124522

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1225124522
Enumeration Date 2006-10-05
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 208 N WALNUT ST
GLENWOOD, IA 51534
United States

Phone: 712-527-4801 | Fax: 712-527-4821
View Map External Link
Primary Practice Address 208 N WALNUT ST
GLENWOOD, IA 51534
United States

Phone: 712-527-4801 | Fax: 712-527-4821
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID IA 4113308
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist IA 5354