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Al Weatherford DDS INC

NPI #1396185633 in Kankakee, Illinois

Provider Information

NPI Number
1396185633
Entity Type
Organization
Organization Name
Al Weatherford DDS INC
Primary Specialty
Dentist - General Practice
Enumeration Date
Jul 1, 2013
Last Updated
Jul 1, 2013

Practice Location

Address
200 E COURT ST
Address 2
SUITE 504
City
Kankakee
State
Illinois
ZIP Code
60901-3843
Phone
(815) 932-3613

Authorized Official

Name
DR. ALVIN D WEATHERFORD JR., DDS
Title
DENTIST
Phone
(815) 932-3616

Specialties & Taxonomy Codes

Specialty
Dentist - General Practice — General Practice

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