Provider Demographics
NPI:1164562088
Name:DALE R SIEMER DDS INC
Entity Type:Organization
Organization Name:DALE R SIEMER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIEMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-321-3003
Mailing Address - Street 1:3666 PAXTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1568
Mailing Address - Country:US
Mailing Address - Phone:513-321-3003
Mailing Address - Fax:513-321-2523
Practice Address - Street 1:3666 PAXTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1568
Practice Address - Country:US
Practice Address - Phone:513-321-3003
Practice Address - Fax:513-321-2523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty