# DR DANIEL ANDREW WEAVER PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Restorative Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528922036
- **Authorized official:** DANIEL WEAVER DDS (OWNER/DENTIST)
- **Authorized official phone:** (337) 478-3123

## Contact information

- **Practice address:** 715 W COLLEGE ST, LAKE CHARLES, LA 70605-1523
- **Practice address phone:** (337) 478-3123
- **Practice address fax:** (337) 504-7875
- **Mailing address:** 715 W COLLEGE ST, LAKE CHARLES, LA 70605-1523
- **Mailing address phone:** (337) 478-3123
- **Mailing address fax:** (337) 504-7875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2025
- **Last updated:** 02/03/2026