Dr Kenneth Bruce Weddell, DDS | |
111 W Dayton St, Fremont, MI 49412 | |
(231) 924-3600 | |
(231) 924-9720 |
Full Name | Dr Kenneth Bruce Weddell |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 111 W Dayton St, Fremont, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104884147 | NPI | - | NPPES |
D808140 | Other | MI | BCBS |
847376 | Other | UN CONCORDIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 14503 (Michigan) | Primary |
Entity Name | Kenneth B Weddell Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073862819 PECOS PAC ID: 6406084896 Enrollment ID: O20140616000145 |
Mailing Address | Practice Location Address |
---|---|
Dr Kenneth Bruce Weddell, DDS 111 W Dayton St, Po Box 437, Fremont, MI 49412 Ph: (231) 924-3600 | Dr Kenneth Bruce Weddell, DDS 111 W Dayton St, Fremont, MI 49412 Ph: (231) 924-3600 |
Dr. Benjamin Wallace, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 517 N Stone Rd, Fremont, MI 49412 Phone: 231-924-5542 | |
Dr. Gerald Lee Fedelem, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 663 E Main St, Fremont, MI 49412 Phone: 231-924-0790 | |
Dr. Eric Scott Prins, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 855 N Darling Ave, Fremont, MI 49412 Phone: 231-924-4650 | |
Dr. Raymond Prins Iii, DDS Dentist Medicare: Medicare Enrolled Practice Location: 855 N Darling, Fremont, MI 49412 Phone: 231-924-4650 Fax: 231-924-4650 | |
Spencer Joseph Starley, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 517 N Stone Rd Ste 102, Fremont, MI 49412 Phone: 231-924-5542 | |
Dr. Joshua Abrams Fair, DDS Dentist Medicare: Medicare Enrolled Practice Location: 517 N Stone Rd Ste 102, Fremont, MI 49412 Phone: 231-924-5542 |