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NPI Code Detail

MEDICARE: DR. STUART DUCHON D.D.S.

MEDICARE:  DR. STUART  DUCHON  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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry14597OH

General Provider Information

NPI Number : 1255328506
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STUART DUCHON D.D.S.
Provider Business Mailing Address
First Line : 110 S TIPPECANOE DR
Second Line :
City : TIPP CITY
State : OH
Zip : 45371-1140
Country : US
Telephone Number : 937-667-2417
Fax Number : 240-220-7701
Provider Business Practice Location Address
First Line : 110 S TIPPECANOE DR
Second Line :
City : TIPP CITY
State : OH
Zip : 45371-1140
Country : US
Telephone Number : 937-667-2417
Fax Number : 240-220-7701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 08/10/2011

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Directions to “ DR. STUART DUCHON D.D.S.” Practice Location

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