Healthcare Provider Details

I. General information

NPI: 1295912186
Provider Name (Legal Business Name): DANVILLE FAMILY DENTAL, AARON F. LERG DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 S. MARKET STREET
DANVILLE OH
43014
US

IV. Provider business mailing address

P.O. BOX 3 709 S. MARKET ST
DANVILLE OH
43014
US

V. Phone/Fax

Practice location:
  • Phone: 740-599-6882
  • Fax: 740-599-7479
Mailing address:
  • Phone: 740-599-6882
  • Fax: 740-599-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number21328
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18224
License Number StateOH

VIII. Authorized Official

Name: AARON F LERG
Title or Position: PRESIDENT
Credential: DDS
Phone: 740-599-6882