| NPI | 1144465675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A WEAVER President 520-745-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2015-02-19 |