Healthcare Provider Details

I. General information

NPI: 1619237088
Provider Name (Legal Business Name): DAVID GILBERT OSER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2012
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MADISON ST UNIT 619
CHICAGO IL
60607-3372
US

IV. Provider business mailing address

901 W MADISON ST UNIT 619
CHICAGO IL
60607-3372
US

V. Phone/Fax

Practice location:
  • Phone: 608-886-7924
  • Fax:
Mailing address:
  • Phone: 608-886-7924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number019031109
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1856206
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: