MEDICARE: WEBBERSON DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	122300000X	Dentist	4342	NV

General Provider Information

NPI Number	:	1821482423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBBERSON DENTAL LLC

Provider Business Mailing Address
First Line	:	7730 W CHEYENNE AVE STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8412
Country	:	US
Telephone Number	:	702-658-8008
Fax Number	:	702-778-2962

Provider Business Practice Location Address
First Line	:	7730 W CHEYENNE AVE STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8412
Country	:	US
Telephone Number	:	702-658-8008
Fax Number	:	702-778-2962

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. STEPHANI THERESA BATEMAN
Credential	:
Telephone Number	:	702-658-8008

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	11/09/2015

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Directions to “WEBBERSON DENTAL LLC ” Practice Location

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