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Individual

DR. DANTEL WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4100 SHORELINE DR, SPRING PARK, MN 55384-4508
(952) 471-0900
Mailing address
4100 SHORELINE DR, SPRING PARK, MN 55384-4508

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
32282
TX
1223G0001X
General Practice Dentistry
Primary
D13769
MN

Other

Enumeration date
06/29/2015
Last updated
12/12/2016
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