MEDICARE: NEKO LYNN WEBB 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	122300000X	Dentist	12018	NC

General Provider Information

NPI Number	:	1962014696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEKO LYNN WEBB DDS

Provider Business Mailing Address
First Line	:	5209 HORIZON DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28312-8505
Country	:	US
Telephone Number	:	910-257-2617
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 SKIBO RD STE 104
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-3161
Country	:	US
Telephone Number	:	910-605-4106
Fax Number	:

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

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	08/24/2020

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