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Individual

DR. IAN MONTGOMERY WEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
451 SUNCREST TOWN CENTRE DR, MORGANTOWN, WV 26505-1814
(304) 541-2284
Mailing address
31 CHERRY WOOD DR, MORGANTOWN, WV 26508-4237

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
4468
WV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10909
KY

Other

Enumeration date
10/13/2021
Last updated
05/09/2023
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