KELLY WEAVER, DDS
Dentist
Active
Individual
NPI: 1578884235
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist | 122300000X | Yes | D4298 (ID) |
Frequently Asked Questions
NPI 1578884235 is the National Provider Identifier for KELLY WEAVER, DDS, a Dentist provider located in Blackfoot, ID. This NPI was enumerated on June 17, 2010.
KELLY WEAVER, DDS practices at 310 W IDAHO ST, Blackfoot, ID 83221.
Quick Facts
- NPI
- 1578884235
- Type
- Individual
- Enumerated
- Jun 17, 2010
- Last Updated
- Mar 8, 2024
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