| NPI | 1891087672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE E WEAVER Owner/Dentist 850-385-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN13009) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |