Provider Demographics
NPI:1831312594
Name:WEIGAND, RICHARD D (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:WEIGAND
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 1:2700 S SOUTHEAST BLVD
Mailing Address - Street 2:STE.110
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4984
Mailing Address - Country:US
Mailing Address - Phone:509-747-5812
Mailing Address - Fax:
Practice Address - Street 1:2700 S SOUTHEAST BLVD
Practice Address - Street 2:STE.110
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4984
Practice Address - Country:US
Practice Address - Phone:509-747-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice