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General NPI Number Information
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NPI Number | 1447553573
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Entity Type | Organization
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Legal Business Name | DOUGLAS B. WEBER, DDS, A DENTAL INCORPORATION
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Dates
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Enumeration Date | 12/12/2010
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Last Update Date | 12/12/2010
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Provider Practice Location Address
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Address Line | 44404 16TH ST W SUITE 201
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City | LANCASTER
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State | CA
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Zip | 93534-2839
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Country | US
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Telephone | 661-945-3661
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Fax | 661-942-0155
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Provider Business Mailing Address
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Address Line | PO BOX 592
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City | LANCASTER
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State | CA
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Zip | 93584-0592
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Country | US
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Telephone | 661-945-3661
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Fax | 661-942-0155
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. DOUGLAS B WEBER
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Credential | DDS
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Telephone | 661-945-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 37951
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License Number State | CA
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