Weaver, Jack H

Weaver, Jack H is an individual health care provider with primary practice located at 3712 Canyon Lake Dr , Rapid City SD 57702-3198. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Weaver, Jack H can be contacted via phone (605) 342-3939.

Contact Information

Primary practice address
3712 Canyon Lake Dr Rapid City SD 57702-3198
Phone: (605) 342-3939
Fax: (605) 341-2766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X M366 South Dakota

Profile Details

NPI number 1043238389
LBN Legal business name Weaver, Jack H
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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