Provider Demographics
NPI:1538313598
Name:WEBB DENTISTRY
Entity Type:Organization
Organization Name:WEBB DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-968-5112
Mailing Address - Street 1:523 HOLSTON AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2131
Mailing Address - Country:US
Mailing Address - Phone:423-968-5112
Mailing Address - Fax:423-968-5687
Practice Address - Street 1:523 HOLSTON AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-2131
Practice Address - Country:US
Practice Address - Phone:423-968-5112
Practice Address - Fax:423-968-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3188122300000X
TNDS8042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty