Provider Demographics
NPI:1154315638
Name:WEBB, DANIEL G (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:G
Last Name:WEBB
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 1:3600 E STATE ST
Mailing Address - Street 2:STE 301
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-1978
Mailing Address - Country:US
Mailing Address - Phone:815-226-3600
Mailing Address - Fax:
Practice Address - Street 1:3600 E STATE ST
Practice Address - Street 2:STE 301
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-1978
Practice Address - Country:US
Practice Address - Phone:815-226-3600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist