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General NPI Number Information
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NPI Number | 1205029139
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Entity Type | Individual
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Provider Name | DIANA WELLS WEBER DDS
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Gender | Female
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 1811 ARMY BLVD
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 210-221-0826
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Fax | 706-787-2082
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Provider Business Mailing Address
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Address Line | BLDG 38717 38TH STREET USA DENTAC
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City | FT GORDON
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State | GA
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Zip | 30905-5660
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Country | US
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Telephone | 706-787-6927
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Fax | 706-787-2082
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS037167
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS037167
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License Number State | PA
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