Individual
DALE D DALENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 S MAIN ST, OTTAWA, KS 66067-3537
(785) 229-8389
(785) 229-3335
Mailing address
1301 S MAIN ST, OTTAWA, KS 66067-3537
(758) 229-8200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0422901
KS
207X00000X
Orthopaedic Surgery Physician
2010006907
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157550B
—
KS
01
—
23737030
BCBS KCMO CUSHING HOSPITAL PHYSICIAN SERVICES GROUP 43113013
MO
Enumeration date
10/21/2006
Last updated
09/10/2013
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