Provider Demographics
NPI:1700896644
Name:ROBERT S. WEBBER DDS,PA
Entity Type:Organization
Organization Name:ROBERT S. WEBBER DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-836-4400
Mailing Address - Street 1:765 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3331
Mailing Address - Country:US
Mailing Address - Phone:201-836-4400
Mailing Address - Fax:201-801-0768
Practice Address - Street 1:765 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3331
Practice Address - Country:US
Practice Address - Phone:201-836-4400
Practice Address - Fax:201-801-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI00924400261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental