# YOLONDA L WEAVER DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairfax Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588098354
- **Authorized official:** MR. ALIKO MWAISELA (BUSINESS MANAGER)
- **Authorized official phone:** (703) 273-1443

## Contact information

- **Practice address:** 4000 VIRGINIA ST, FAIRFAX, VA 22032-1047
- **Practice address phone:** (703) 273-1443
- **Practice address fax:** (703) 273-9186
- **Mailing address:** 4000 VIRGINIA ST, FAIRFAX, VA 22032-1047
- **Mailing address phone:** (703) 273-1443
- **Mailing address fax:** (703) 273-9186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401410745 | VA | Yes |

## Other

- **Enumeration date:** 08/28/2013
- **Last updated:** 08/28/2013