Organization
DAVID G. SLYBY D.D.S. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GEORGE SLYBY D.D.S. (OWNER/PRESIDENT)
(260) 484-0725
Entity
Organization
Contact information
Practice address
4606 E STATE BLVD, B, FORT WAYNE, IN 46815-6993
(260) 484-0725
Mailing address
4606 E STATE BLVD, B, FORT WAYNE, IN 46815-6993
(260) 484-0725
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010192A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200258780A
—
IN
Enumeration date
07/25/2006
Last updated
01/04/2013
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