MEDICARE: DR. CAROLINE MARIE WEBBER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	10194	FL
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	0401411368	VA

General Provider Information

NPI Number	:	1740250430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINE MARIE WEBBER DDS

Provider Business Mailing Address
First Line	:	303A 55TH ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-2213
Country	:	US
Telephone Number	:	757-375-3988
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 MCCOMAS WAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23445
Country	:	US
Telephone Number	:	757-426-6155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	08/08/2014

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