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General NPI Number Information
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NPI Number | 1386881431
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Entity Type | Organization
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Legal Business Name | RICHARD C. WEBER, D.D.S., LLC
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 9780 LANTERN RD SUITE 110
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City | FISHERS
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State | IN
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Zip | 46037-4092
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Country | US
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Telephone | 317-849-0421
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Fax | 317-849-0425
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Provider Business Mailing Address
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Address Line | 9780 LANTERN RD SUITE 110
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City | FISHERS
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State | IN
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Zip | 46037-4092
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Country | US
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Telephone | 317-849-0421
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Fax | 317-849-0425
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Authorized Official
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Title or Position | DENTIST - OWNER
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Name | DR. RICHARD WEBER
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Credential | DDS
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Telephone | 317-849-0421
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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 | 12007910
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License Number State | IN
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