KELLY WEAVER

BLACKFOOT, ID
NPI1578884235
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: ID  D4298)
Enumeration Date2010-06-17
Last Update Date2024-03-08
Business Address
KELLY WEAVER DDS
310 W IDAHO ST
BLACKFOOT, ID 83221-1710
Phone number: 208-785-2255
Mailing Address
KELLY WEAVER DDS
PO BOX 248
BLACKFOOT, ID 83221-0248
Phone number: 208-785-2255