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General NPI Number Information
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NPI Number | 1285831776
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Entity Type | Organization
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Legal Business Name | WEBSTER FAMILY DENTISTRY, INC
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5371 GLOVER LN
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City | MILTON
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State | FL
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Zip | 32570-4104
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Country | US
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Telephone | 850-623-0379
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Fax | 850-623-9607
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Provider Business Mailing Address
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Address Line | 5371 GLOVER LN
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City | MILTON
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State | FL
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Zip | 32570-4104
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Country | US
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Telephone | 850-623-0379
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Fax | 850-623-9607
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS A WEBSTER
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Credential | DDS
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Telephone | 850-623-0379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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