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Mark S Weaver, DDS
Pediatric Dentist in Austin, Texas
NPI 1124138755

Mark S Weaver is a Pediatric Dentist based in Austin, TX and is specialized in Pediatric Dentistry. Mark S Weaver practices in Austin, TX and has the professional credentials of DDS. The NPI Number for Mark S Weaver is 1124138755 and holds a License No. 10751 (Texas).

The current practice location address for Mark S Weaver is 4638 Westgate Blvd, Austin, TX and can be reached out via phone at 512-892-2443 and via fax at 512-892-2002.

Location: 4638 Westgate Blvd, Austin, TX, 78745-1461
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124138755
Provider Name
Mark S Weaver
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
4638 Westgate Blvd, Austin, TX, 78745-1461
Phone Number
512-892-2443
Fax Number
512-892-2002
Provider Enumeration Date
08/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B10751 01 TX CHIP
institution
Provider Business Practice Location Address Details
Address
4638 Westgate Blvd
City
Austin
State
Texas
Zip
78745-1461
Phone Number
512-892-2443
Fax Number
512-892-2002
person
Provider Business Mailing Address Details
Address
4638 Westgate Blvd
City
Austin
State
Texas
Zip
78745-1461
Phone Number
512-892-2443
Fax Number
512-892-2002
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
10751 (Texas)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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