Provider Demographics
NPI:1073583795
Name:FORSEE, DONALD O (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:O
Last Name:FORSEE
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 1:207 SPARKS AVE
Mailing Address - Street 2:SUITE 002
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3739
Mailing Address - Country:US
Mailing Address - Phone:812-282-8467
Mailing Address - Fax:812-282-3067
Practice Address - Street 1:207 SPARKS AVE
Practice Address - Street 2:SUITE 002
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3739
Practice Address - Country:US
Practice Address - Phone:812-282-8467
Practice Address - Fax:812-282-3067
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007773174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200384560AMedicaid
INU88290Medicare UPIN
IN200384560AMedicaid