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Individual

DOUGLAS S WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
326 4TH ST, STE 205, JUNEAU, AK 99801-1146
(907) 586-3220
(907) 586-2905
Mailing address
326 4TH ST, STE 205, JUNEAU, AK 99801-1146
(907) 586-3220
(907) 586-2905

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
492
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1437281094
NPI - TYPE 2 #
AK
05
DD0492
AK
Enumeration date
02/28/2006
Last updated
07/09/2007
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