Provider Demographics
NPI:1972898047
Name:WEEKS, GEORGE C III (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:WEEKS
Suffix:III
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 1:60 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2070
Mailing Address - Country:US
Mailing Address - Phone:904-259-4649
Mailing Address - Fax:904-259-5926
Practice Address - Street 1:60 WEST BLVD
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2070
Practice Address - Country:US
Practice Address - Phone:904-259-4649
Practice Address - Fax:904-259-5926
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 79731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice