Provider Demographics
NPI:1003914847
Name:PAINTER, DAVID DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DEAN
Last Name:PAINTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-1633
Mailing Address - Country:US
Mailing Address - Phone:260-925-9161
Mailing Address - Fax:260-925-9171
Practice Address - Street 1:751 NORTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-1633
Practice Address - Country:US
Practice Address - Phone:260-925-9161
Practice Address - Fax:260-925-9171
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009681B122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist