MEDICARE: DR. DAVID GILBERT OSER 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	1223G0001X	General Practice Dentistry	DN1856206	MA
2	1223E0200X	Endodontics	019031109	IL

General Provider Information

NPI Number	:	1619237088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GILBERT OSER DDS

Provider Business Mailing Address
First Line	:	901 W MADISON ST UNIT 619
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3372
Country	:	US
Telephone Number	:	608-886-7924
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 W MADISON ST UNIT 619
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3372
Country	:	US
Telephone Number	:	608-886-7924
Fax Number	:

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

Provider Enumeration Date	:	05/20/2012
Last Update Date	:	11/09/2018

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