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Individual

DR. JAMES R WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
35 S CREASY LN STE 3, LAFAYETTE, IN 47905-5254
(765) 446-0042
(765) 446-0046
Mailing address
3974 BELL CT, NAMPA, ID 83686-1411
(208) 284-0054

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011732A
IN

Other

Enumeration date
04/23/2007
Last updated
12/10/2020
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