Provider Demographics
NPI:1740250430
Name:WEBBER, CAROLINE MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MARIE
Last Name:WEBBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303A 55TH ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2213
Mailing Address - Country:US
Mailing Address - Phone:757-375-3988
Mailing Address - Fax:
Practice Address - Street 1:2116 MCCOMAS WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23445
Practice Address - Country:US
Practice Address - Phone:757-426-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101941223S0112X
VA04014113681223S0112X
CA362991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery