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General NPI Number Information
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NPI Number | 1972840296
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Entity Type | Individual
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Provider Name | BRANDON J WEBB D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 6600 MERCY CT STE 200
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City | FAIR OAKS
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State | CA
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Zip | 95628-3198
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Country | US
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Telephone | 916-472-1562
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 E ROSEVILLE PKWY SUITE 140-370
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City | ROSEVILLE
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State | CA
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Zip | 95661-3078
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Country | US
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Telephone | 916-481-3636
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Fax | 916-481-3637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 62128
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License Number State | CA
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