Organization
BRYAN A WEYNETH DDS PC
Active
Other names
BRYAN A WEYNETH DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY HERNANDEZ CREDENTIALING AGENT (CREDENTIALING AGENT CONTRACT LABOR)
(928) 779-4404
Entity
Organization
Contact information
Practice address
1100 SHERMAN AVE STE 1031100, NAPERVILLE, IL 60563-8608
(630) 369-5225
(630) 369-7416
Mailing address
1100 SHERMAN AVE STE 1031100, NAPERVILLE, IL 60563-8608
(630) 369-5225
(630) 369-7416
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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