Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY WEAVER, DDS
Active Sole ProprietorKELLY WEAVER, DDS is a Dentist healthcare provider located in BLACKFOOT, Idaho. NPI 1578884235 is currently active in the NPPES registry. Verify at CMS.
Dentist · BLACKFOOT, ID
Registration Details
- NPI Number
- 1578884235
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 17, 2010 (16.129658369722 yrs)
- Last Updated
- Mar 8, 2024
- License
-
D4298 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
310 W IDAHO STBLACKFOOT, ID, 832211710Browse ID providers · Browse ZIP 83221
- Phone
- 2087852255
- Fax
- 2087852275
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in BLACKFOOT, ID
| Name | Credential | NPI |
|---|---|---|
| DR. RICHARD RUSSELL BURT | DDS | 1700894771 |
| DR. CHARLES GORDON SIMPSON | DDS | 1194869990 |
| DR. PAUL LLOYD HANSEN | D.D.S. | 1831415447 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.