Organization
DG ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG W PENNO (CEO)
(937) 320-5088
Entity
Organization
Contact information
Practice address
75 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 320-5050
(937) 320-5060
Mailing address
75 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 320-5050
(937) 320-5060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H071150
MEDICARE PTAN
OH
Enumeration date
07/15/2011
Last updated
10/31/2013
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