Provider Demographics
NPI:1154542033
Name:WEAVER SHEPARD, CHRISTI (DDS, PA)
Entity type:Individual
Prefix:DR
First Name:CHRISTI
Middle Name:
Last Name:WEAVER SHEPARD
Suffix:
Gender:F
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 N RODNEY PARHAM RD., SUITE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212
Mailing Address - Country:US
Mailing Address - Phone:501-228-4900
Mailing Address - Fax:501-225-5789
Practice Address - Street 1:4200 N RODNEY PARHAM RD., SUITE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212
Practice Address - Country:US
Practice Address - Phone:501-228-4900
Practice Address - Fax:501-225-5789
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist