Ronald D Weaks DDS INC
Dentist in Greenville, TX. Organization (NPI-2).
NPI number1073679080
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1073679080
- Entity type
- Organization (NPI-2)
- Legal business name
- Ronald D Weaks DDS INC
- Organization subpart
- No
- Enumeration date
- Dec 28, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 9643 | TX | Yes |
Other names
- Longbranch Dental Center (Doing Business As)
Practice location
4250 Joe Ramsey BlvdGreenville, TX 75401
Phone 903-455-4161 · Fax 903-455-7510
Mailing address
4250 Joe Ramsey BlvdGreenville, TX 75401
Phone 903-455-4161 · Fax 903-455-7510
Authorized official
Ronald D Weaks
President Owner
9034554161
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