Autumn Ridge Dental Partnership
NPI #1275750531 in Kosciusko, Mississippi
Provider Information
- NPI Number
- 1275750531
- Entity Type
- Organization
- Organization Name
- Autumn Ridge Dental Partnership
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 19, 2007
- Last Updated
- Jan 3, 2011
Practice Location
- Address
- 101 RIDGEWOOD CIR
- City
- Kosciusko
- State
- Mississippi
- ZIP Code
- 39090-3265
- Phone
- (662) 289-7076
Authorized Official
- Name
- DR. DONALD Q WEAVER, D.M.D.
- Title
- PARTNER
- Phone
- (662) 289-7076
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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