Provider Demographics
NPI:1417042326
Name:WEBB, DAVID MARCUS (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MARCUS
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 1:1911 LELARAY ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2803
Mailing Address - Country:US
Mailing Address - Phone:719-633-7774
Mailing Address - Fax:719-404-3267
Practice Address - Street 1:1911 LELARAY ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2803
Practice Address - Country:US
Practice Address - Phone:719-633-7774
Practice Address - Fax:719-404-3267
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO63791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice