Provider Demographics
NPI:1780170118
Name:J. DUSTIN WEBB, DMD, P.C.
Entity type:Organization
Organization Name:J. DUSTIN WEBB, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DUSTIN
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-295-5253
Mailing Address - Street 1:385 E PENNY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-8123
Mailing Address - Country:US
Mailing Address - Phone:480-295-5253
Mailing Address - Fax:
Practice Address - Street 1:703 VALLEY MALL PKWY
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4839
Practice Address - Country:US
Practice Address - Phone:480-295-5253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60301378261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental