MEDICARE: RICHARD D WEIGAND DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1013153097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD D WEIGAND DDS

Provider Business Mailing Address
First Line	:	2700 S SOUTHEAST BLVD STE 110
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-4984
Country	:	US
Telephone Number	:	509-747-5812
Fax Number	:	509-747-3153

Provider Business Practice Location Address
First Line	:	2700 S SOUTHEAST BLVD STE 110
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-4984
Country	:	US
Telephone Number	:	509-747-5812
Fax Number	:	509-747-3153

Authorized Official
Title or Position	:	OFFICE COORDINATOR
Name	:	SHARON M ARTHUR
Credential	:
Telephone Number	:	509-747-5812

Provider Enumeration Date	:	12/23/2008
Last Update Date	:	12/23/2008

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