NPI 1043238389

Jack H Weaver, DDS

Practitioner General Practice Dentistry Rapid City, SD

Practice location

Address: 3712 Canyon Lake Dr, Rapid City, SD 57702-3198
Phone: (605) 342-3939
Fax: (605) 341-2766
Mailing address: 4716 Guest Rd, Rapid City, SD 57702-4815

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence M366 (SD)

Other Dentist providers in South Dakota →

Registry record

NPI: 1043238389
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.