| NPI | 1972146470 |
|---|---|
| Former Legal Business Name | BRYAN A WEYNETH DDS PC |
| Entity Type | Organization |
| Authorized Contact | DOROTHY HERNANDEZ Credentialing Agent Contract Labor 928-779-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |