DR. Grant Wendell Weathers JR., D.D.S.

NPI #1801921010 in Sikeston, Missouri

Provider Information

NPI Number: 1801921010
Entity Type: Individual
Name: DR. Grant Wendell Weathers JR., D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Feb 21, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 405 TANNER ST
City: Sikeston
State: Missouri
ZIP Code: 63801-4272
Phone: (573) 471-5155

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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