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Organization
WEBBER DENTISTRY AT SOUTH PARK
Active
Organization
WEBBER DENTISTRY AT SOUTH PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SPURGEON W WEBBER DDS (OWNER/PRESIDENT)
(704) 247-4030
Entity
Organization
Contact information
Practice address
5940 FAIRVIEW RD, SUITE # 103, CHARLOTTE, NC 28210-3125
(704) 247-4030
Mailing address
5940 FAIRVIEW RD, SUITE # 103, CHARLOTTE, NC 28210-3125
(704) 247-4030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5647
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101749
PROVIDER ID UNITED CONCORDIA
NC
01
—
1265500839
INDIVIDUAL NPI
NC
Enumeration date
08/07/2013
Last updated
08/07/2013
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