Provider Demographics
NPI:1235201260
Name:GIESTING, DALE ALVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ALVIN
Last Name:GIESTING
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 1:10130 OXFORD PIKE
Mailing Address - Street 2:PO BOX D
Mailing Address - City:BROOKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47012
Mailing Address - Country:US
Mailing Address - Phone:765-647-2511
Mailing Address - Fax:765-647-6840
Practice Address - Street 1:10130 OXFORD PIKE
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-9414
Practice Address - Country:US
Practice Address - Phone:765-647-2511
Practice Address - Fax:765-647-6840
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist