MEDICARE: DR. DAVID KIRKWOOD SICKINGER 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
1	122300000X	Dentist	16820	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609874866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID KIRKWOOD SICKINGER DDS

Provider Business Mailing Address
First Line	:	316 N TUSCARAWAS AVE
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-3142
Country	:	US
Telephone Number	:	330-364-6422
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 N TUSCARAWAS AVE
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-3142
Country	:	US
Telephone Number	:	330-364-6422
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	03/18/2008

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