# DAVID G. SLYBY D.D.S. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215959325
- **Authorized official:** DR. DAVID GEORGE SLYBY D.D.S. (OWNER/PRESIDENT)
- **Authorized official phone:** (260) 484-0725

## Contact information

- **Practice address:** 4606 E STATE BLVD, B, FORT WAYNE, IN 46815-6993
- **Practice address phone:** (260) 484-0725
- **Mailing address:** 4606 E STATE BLVD, B, FORT WAYNE, IN 46815-6993
- **Mailing address phone:** (260) 484-0725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010192A | IN | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 01/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200258780A | — | IN |