MEDICARE: DAVID PAUL CHAVE D.D.S.

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	30022257	OH

General Provider Information

NPI Number	:	1205045754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID PAUL CHAVE D.D.S.

Provider Business Mailing Address
First Line	:	3360 TREMONT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2111
Country	:	US
Telephone Number	:	614-451-7377
Fax Number	:	614-538-2490

Provider Business Practice Location Address
First Line	:	3360 TREMONT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-2111
Country	:	US
Telephone Number	:	614-451-7377
Fax Number	:	614-538-2490

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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