Individual
DR. DAVID SLYBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4606 E STATE BLVD, B, FORT WAYNE, IN 46815-6993
(260) 484-0725
Mailing address
4606 EAST STATE BLVD, B, FORT WAYNE, IN 46815
(260) 484-0725
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010192
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200258780A
—
IN
Enumeration date
01/09/2013
Last updated
01/09/2013
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