Dr. William Wofford Weller, DDS
Dentist, General Practice in Jacksonville, IL. Individual provider (NPI-1).
NPI number1245304062
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1245304062
- Entity type
- Individual (NPI-1)
- Name
- Dr. William Wofford Weller
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 20, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019018008 | IL | Yes |
| 1223G0001X | Dentist, General Practice | 4113 | AZ | |
| 1223G0001X | Dentist, General Practice | 17459 | TX |
Practice location
1614 W Lafayette AveJacksonville, IL 62650-1000
Phone 817-245-4516 · Fax 217-245-7906
Mailing address
1614 W Lafayette AveJacksonville, IL 62650-1000
Phone 817-245-4516 · Fax 217-245-7906
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