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Organization

EASTPARK DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KARL WEAVER (DENTIST)
(608) 222-8232
Entity
Organization

Contact information

Practice address
5100 EASTPARK BLVD, SUITE 110, MADISON, WI 53718-2149
(608) 222-8232
(608) 222-8340
Mailing address
5100 EASTPARK BLVD, SUITE 110, MADISON, WI 53718-2149
(608) 222-8232
(608) 222-8340

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4943
WI

Other

Enumeration date
10/22/2009
Last updated
10/22/2009
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