Individual
DR. COLE A. WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
6900 YELLOWTAIL RD, CHEYENNE, WY 82009-6102
(307) 632-2480
Mailing address
6900 YELLOWTAIL RD, CHEYENNE, WY 82009-6102
(307) 632-2480
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1369
WY
390200000X
Student in an Organized Health Care Education/Training Program
30368
IA
Other
Enumeration date
01/31/2013
Last updated
07/28/2014
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