Individual
DR. JESSE ROBERT WEAVER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4205 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7549
(410) 664-4460
Mailing address
4205 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7549
(410) 664-4460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7164
MD
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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