# MICHAEL D WEAVER DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1548427776
- **Authorized official:** DR. MICHAEL DON WEAVER DDS (PRES DDS)
- **Authorized official phone:** (580) 657-3117

## Contact information

- **Practice address:** 16931 US HWY 70, LONE GROVE, OK 73443-1270
- **Practice address phone:** (580) 657-3117
- **Practice address fax:** (580) 657-8081
- **Mailing address:** PO BOX 1270, LONE GROVE, OK 73443-1270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4275 | OK | Yes |

## Other

- **Enumeration date:** 05/16/2008
- **Last updated:** 05/16/2008