Individual
DR. ANDREW T WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1900 DIVISION ST W UNIT 2, BEMIDJI, MN 56601-6397
(218) 333-8832
Mailing address
9555 N GRACE LAKE RD SE, BEMIDJI, MN 56601-7383
(218) 368-3331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13523
MN
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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