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General NPI Number Information
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NPI Number | 1659501724
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Entity Type | Organization
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Legal Business Name | BARRY L. WEEKS, D.M.D. PC
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 605 N MAIN ST
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City | WATER VALLEY
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State | MS
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Zip | 38965-2525
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Country | US
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Telephone | 662-473-1133
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 806
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City | WATER VALLEY
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State | MS
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Zip | 38965-0806
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Country | US
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Telephone | 662-473-1133
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. BARRY L. WEEKS
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Credential | D.M.D.
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Telephone | 662-473-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 203783
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License Number State | MS
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