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General NPI Number Information
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NPI Number | 1225318249
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Entity Type | Individual
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Provider Name | MAGARETTE WEATHERWAX D.D.S
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Gender | Female
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 5690 THREE NOTCH D RD STE 100
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City | CROZET
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State | VA
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Zip | 22932-3173
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Country | US
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Telephone | 434-823-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 5690 THREE NOTCH D RD STE 100
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City | CROZET
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State | VA
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Zip | 22932-3173
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Country | US
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Telephone | 434-823-4080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401413300
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License Number State | VA
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