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General NPI Number Information
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NPI Number | 1508236258
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Entity Type | Organization
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Legal Business Name | GARY E. WEBER, DDS, PC
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 1910 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2834
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Country | US
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Telephone | 765-825-1121
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Fax | 765-827-1197
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Provider Business Mailing Address
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Address Line | 1910 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2834
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Country | US
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Telephone | 765-825-1121
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Fax | 765-827-1197
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Authorized Official
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Title or Position | DDS/OWNER
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Name | DR. GARY E WEBER
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Credential | DDS
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Telephone | 765-825-1121
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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 | 12007534A
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License Number State | IN
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