Provider Demographics
NPI:1821482423
Name:WEBBERSON DENTAL LLC
Entity Type:Organization
Organization Name:WEBBERSON DENTAL LLC
Other - Org Name:MICHAEL P. WEBBERSON DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANI
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:BATEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-658-8008
Mailing Address - Street 1:7730 W CHEYENNE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8412
Mailing Address - Country:US
Mailing Address - Phone:702-658-8008
Mailing Address - Fax:702-778-2962
Practice Address - Street 1:7730 W CHEYENNE AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8412
Practice Address - Country:US
Practice Address - Phone:702-658-8008
Practice Address - Fax:702-778-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4342122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty