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NPI Code Detail

MEDICARE: DR. DAVID MICHAEL PREBLE DDS

MEDICARE: DR. DAVID MICHAEL PREBLE 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
1122300000XDentistDN12044FL

General Provider Information

NPI Number : 1013910637
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID MICHAEL PREBLE DDS
Provider Business Mailing Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1800
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-440-2756
Fax Number : 312-440-2520
Provider Business Practice Location Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1800
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-440-2756
Fax Number : 312-440-2520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 12/13/2012

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Directions to “ DR. DAVID MICHAEL PREBLE DDS” Practice Location

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