Individual
DR. MARY KATHERINE WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1063 10TH ST, CHARLESTON, IL 61920-2885
(217) 345-2176
(217) 345-2195
Mailing address
1063 10TH ST, CHARLESTON, IL 61920-2885
(217) 345-2176
(217) 345-2195
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1924312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1924312
LISENSE NUMBER
IL
01
—
201122
AGA NUMBER
IL
Enumeration date
11/16/2006
Last updated
07/09/2007
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