Provider Demographics
NPI:1508086646
Name:WEBBER, LARRY N (DDS)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:N
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 1:301 W HUNTINGTON DRIVE
Mailing Address - Street 2:SUITE 509
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-1510
Mailing Address - Country:US
Mailing Address - Phone:626-446-3023
Mailing Address - Fax:626-446-1043
Practice Address - Street 1:301 W HUNTINGTON DRIVE
Practice Address - Street 2:SUITE 509
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-1510
Practice Address - Country:US
Practice Address - Phone:626-446-3023
Practice Address - Fax:626-446-1043
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist