Provider Demographics
NPI:1356505069
Name:DEHAY, WEAVER GRIGGS (DDS)
Entity Type:Individual
Prefix:DR
First Name:WEAVER
Middle Name:GRIGGS
Last Name:DEHAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2208
Mailing Address - Country:US
Mailing Address - Phone:972-937-8433
Mailing Address - Fax:972-938-9655
Practice Address - Street 1:1408 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2208
Practice Address - Country:US
Practice Address - Phone:972-937-8433
Practice Address - Fax:972-938-9655
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice