Individual
LAURA ANN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18689
OH
1223G0001X
General Practice Dentistry
30-01-8689
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0766620
—
OH
Enumeration date
05/11/2006
Last updated
03/03/2014
Update your record
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