MEDICARE: DR. DAVID W. MENNING DDS

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	1223G0001X	General Practice Dentistry	19544	OH

General Provider Information

NPI Number	:	1205865581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W. MENNING DDS

Provider Business Mailing Address
First Line	:	248 S MIAMI ST
Second Line	:
City	:	WEST MILTON
State	:	OH
Zip	:	45383-1527
Country	:	US
Telephone Number	:	937-698-4184
Fax Number	:	937-698-3533

Provider Business Practice Location Address
First Line	:	248 S MIAMI ST
Second Line	:
City	:	WEST MILTON
State	:	OH
Zip	:	45383-1527
Country	:	US
Telephone Number	:	937-698-4184
Fax Number	:	937-698-3533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/08/2007

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