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Individual

DR. RUSSELL EVERETTE WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
8035 MADISON AVE, SUITE E-4, CITRUS HEIGHTS, CA 95610-7949
(916) 965-1200
(916) 965-3524
Mailing address
8035 MADISON AVE, SUITE E-4, CITRUS HEIGHTS, CA 95610-7949
(916) 965-1200
(916) 965-3524

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
28256
CA

Other

Enumeration date
09/26/2006
Last updated
06/24/2015
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