Individual
STEPHEN GREGORY WEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
111 NORTH JEFFERSON STREET, SUITE 4, MARSHALL, MI 49068-1553
(269) 781-7531
Mailing address
15126 WALTERS DRIVE, MARSHALL, MI 49068-9606
(269) 781-6491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014165
MI
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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