MEDICARE: DAVID C COMPTON 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	12009555	IN

General Provider Information

NPI Number	:	1508968728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C COMPTON D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 314
Second Line	:
City	:	ELLETTSVILLE
State	:	IN
Zip	:	47429-0314
Country	:	US
Telephone Number	:	812-876-3343
Fax Number	:	812-876-7325

Provider Business Practice Location Address
First Line	:	5915 WEST HIGHWAY 46
Second Line	:
City	:	ELLETTSVILLE
State	:	IN
Zip	:	47429-0518
Country	:	US
Telephone Number	:	812-876-7330
Fax Number	:	812-876-7325

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	12/14/2010

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