Provider Demographics
NPI:1437384864
Name:MICHAEL D WEBB DDS PC
Entity Type:Organization
Organization Name:MICHAEL D WEBB DDS PC
Other - Org Name:THE CENTER FOR PEDIATRIC DENTISTRY AND SEDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-539-3794
Mailing Address - Street 1:8930 HOLLOW OAK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6871
Mailing Address - Country:US
Mailing Address - Phone:804-839-3064
Mailing Address - Fax:
Practice Address - Street 1:10145 MIDLOTHIAN TURNPIKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-839-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL D WEBB DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412000261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental