Individual
DR. GREGORY S DENSBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
824 E BROADWAY, LOGANSPORT, IN 46947-3135
(574) 737-8313
(574) 735-2130
Mailing address
824 E BROADWAY, LOGANSPORT, IN 46947-3135
(574) 737-8313
(574) 735-2130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002450B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000635210
ANTHEM BCBS
IN
05
—
200079460
—
IN
Enumeration date
07/02/2006
Last updated
12/26/2009
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