Individual
DR. CHRISTOPHER DEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5735 MEEKER RD, GREENVILLE, OH 45331-1180
(937) 548-9680
(937) 548-2087
Mailing address
5735 MEEKER RD, GREENVILLE, OH 45331-1180
(937) 548-9680
(937) 548-2087
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.020731
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30.020731
STATE TAX IDENTIFICATION
OH
01
—
31-1745865
TAX IDENTIFICATION NUMBER
OH
Enumeration date
12/11/2006
Last updated
07/21/2011
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