MEDICARE: DAYTON FAMILY PRACTICE ASSOCIATES INC

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	207Q00000X	Family Medicine Physician	4084	OH

General Provider Information

NPI Number	:	1659371953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON FAMILY PRACTICE ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3328 S SMITHVILLE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45420-1500
Country	:	US
Telephone Number	:	937-254-5661
Fax Number	:	937-254-7367

Provider Business Practice Location Address
First Line	:	3328 S SMITHVILLE RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45420-1500
Country	:	US
Telephone Number	:	937-254-5661
Fax Number	:	937-254-7367

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID A DENKA
Credential	:	DO
Telephone Number	:	937-254-5661

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	06/25/2010

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