Provider Demographics
NPI:1508021957
Name:WEAKS, RONALD DAVID (DDS)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DAVID
Last Name:WEAKS
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 1:4250 JOE RAMSEY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7851
Mailing Address - Country:US
Mailing Address - Phone:903-455-4161
Mailing Address - Fax:903-455-7510
Practice Address - Street 1:4250 JOE RAMSEY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7851
Practice Address - Country:US
Practice Address - Phone:903-455-4161
Practice Address - Fax:903-455-7510
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist