Healthcare Provider Details

I. General information

NPI: 1760398424
Provider Name (Legal Business Name): CARA WEBB CRDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 N WICKHAM RD STE 12
MELBOURNE FL
32940-7979
US

IV. Provider business mailing address

117 12TH AVE
INDIALANTIC FL
32903-3250
US

V. Phone/Fax

Practice location:
  • Phone: 561-699-8722
  • Fax:
Mailing address:
  • Phone: 561-699-8722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH22733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: