Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 22910 | TX |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 64254 | CA |
NPI | 1255359469 |
---|---|
Provider Name | Dr. David Evans Webb |
First Address | Fairfield, CA 94533-4932 |
Second Address | Fairfield, CA 94533-4932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 04/08/2015 |