Individual
CLINTON E WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1202 FARMERS LN, SANTA ROSA, CA 95405-6707
(707) 526-7036
(707) 526-4569
Mailing address
1202 FARMERS LN, SANTA ROSA, CA 95405-6707
(707) 526-7036
(707) 526-4569
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
28254
CA
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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