# DR. JOHN K. WEAVER DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508398249
- **Authorized official:** DR. JOHN K WEAVER DMD, PLLC (DENTIST)
- **Authorized official phone:** (859) 252-0314

## Contact information

- **Practice address:** 540 E MAIN ST, LEXINGTON, KY 40508-2328
- **Practice address phone:** (859) 252-0314
- **Practice address fax:** (859) 252-0734
- **Mailing address:** 540 E MAIN ST, LEXINGTON, KY 40508-2328
- **Mailing address phone:** (859) 252-0314
- **Mailing address fax:** (859) 252-0734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9678 | KY | Yes |

## Other

- **Enumeration date:** 03/31/2017
- **Last updated:** 03/31/2017