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General NPI Number Information
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NPI Number | 1831676675
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Entity Type | Organization
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Legal Business Name | FONDA WEBBER DDS INC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 8329 FAIR OAKS BLVD STE D
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City | CARMICHAEL
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State | CA
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Zip | 95608-1949
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Country | US
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Telephone | 916-769-3189
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Fax |
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Provider Business Mailing Address
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Address Line | 1457 MARIETTA CT
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City | FOLSOM
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State | CA
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Zip | 95630-6640
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Country | US
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Telephone | 916-769-3189
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DAMON WEBBER
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Credential |
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Telephone | 916-571-2781
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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 |
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License Number State |
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