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General NPI Number Information
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NPI Number | 1750461133
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Entity Type | Organization
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Legal Business Name | DAN H. CONSTABLE, D.D.S. & ASSOCIATES, INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11440 LIPPELMAN RD
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City | CINCINNATI
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State | OH
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Zip | 45246-4098
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Country | US
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Telephone | 513-771-9190
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Fax | 513-771-6208
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Provider Business Mailing Address
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Address Line | 11440 LIPPELMAN RD
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City | CINCINNATI
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State | OH
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Zip | 45246-4098
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Country | US
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Telephone | 513-771-9190
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Fax | 513-771-6208
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAN H CONSTABLE
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Credential | D.D.S.
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Telephone | 513-771-9190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15411
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License Number State | OH
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