Provider Demographics
NPI:1104419944
Name:WEBB DENTISTRY PLLC
Entity type:Organization
Organization Name:WEBB DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-968-5112
Mailing Address - Street 1:523 HOLSTON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2148
Mailing Address - Country:US
Mailing Address - Phone:423-968-5112
Mailing Address - Fax:423-968-5687
Practice Address - Street 1:523 HOLSTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-2148
Practice Address - Country:US
Practice Address - Phone:423-968-5112
Practice Address - Fax:423-968-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty