| NPI | 1275750531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD Q WEAVER Partner 662-289-7076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 1686-75) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2011-01-03 |