# DAVID DIBBLE DDS PC

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

## Provider details

- **NPI number:** 1508958273
- **Authorized official:** DR. DAVID LEE DIBBLE DDS (PRESIDENT)
- **Authorized official phone:** (231) 544-8115

## Contact information

- **Practice address:** 2550 N MAIN STREET, CENTRAL LAKE, MI 49622
- **Practice address phone:** (231) 544-8115
- **Practice address fax:** (231) 544-6012
- **Mailing address:** PO BOX 457, 2550 N MAIN STREET, CENTRAL LAKE, MI 49622
- **Mailing address phone:** (231) 544-8115
- **Mailing address fax:** (231) 544-6012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901013248 | MI | Yes |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 08/22/2020