Provider Demographics
NPI:1417031634
Name:WEBBER, TERRY NOBLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:NOBLE
Last Name:WEBBER
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 1:2021 MONTROSE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1670
Mailing Address - Country:US
Mailing Address - Phone:818-248-2237
Mailing Address - Fax:818-248-6873
Practice Address - Street 1:2021 MONTROSE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1670
Practice Address - Country:US
Practice Address - Phone:818-248-2237
Practice Address - Fax:818-248-6873
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist