Provider Demographics
NPI:1831673722
Name:WEBB, BILLI (RDH)
Entity Type:Individual
Prefix:
First Name:BILLI
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15622 LAUREN
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2629
Mailing Address - Country:US
Mailing Address - Phone:810-334-8574
Mailing Address - Fax:
Practice Address - Street 1:53 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1109
Practice Address - Country:US
Practice Address - Phone:248-268-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2012015886124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist