Individual
MIKAELA WEEDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
710 N BEAVER ST BLDG 5, FLAGSTAFF, AZ 86001-3146
(928) 774-4726
Mailing address
9959 BLACKHORSE RD, FLAGSTAFF, AZ 86004-9781
(602) 680-0322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011414
AZ
Other
Enumeration date
06/09/2022
Last updated
03/06/2026
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