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NPI Code Detail

MEDICARE: DONALD JOHN ELSBERND SR. D.D.S.

MEDICARE: DONALD JOHN ELSBERND SR. 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
1122300000XDentist18213OH

General Provider Information

NPI Number : 1871701128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD JOHN ELSBERND SR. D.D.S.
Provider Business Mailing Address
First Line : 3543 HIGH POINT CT
Second Line :
City : DAYTON
State : OH
Zip : 45440-3569
Country : US
Telephone Number : 937-320-0338
Fax Number :
Provider Business Practice Location Address
First Line : 825 TROY ST
Second Line :
City : DAYTON
State : OH
Zip : 45404-1852
Country : US
Telephone Number : 937-222-9923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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