DR. Russell Everette Weaver, D.D.S.

NPI #1003917204 in Citrus Heights, California

Provider Information

NPI Number: 1003917204
Entity Type: Individual
Name: DR. Russell Everette Weaver, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Periodontics
Credential: D.D.S.
Enumeration Date: Sep 26, 2006
Last Updated: Jun 24, 2015

Practice Location

Address: 8035 MADISON AVE
Address 2: SUITE E-4
City: Citrus Heights
State: California
ZIP Code: 95610-7949
Phone: (916) 965-1200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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