Provider Demographics
NPI:1275656720
Name:HARTMAN, DAVID EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:HARTMAN
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 1:2410 SYLVESTER DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1920
Mailing Address - Country:US
Mailing Address - Phone:937-294-1571
Mailing Address - Fax:
Practice Address - Street 1:7111 N MAIN ST
Practice Address - Street 2:SUITE 40
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2565
Practice Address - Country:US
Practice Address - Phone:937-274-1127
Practice Address - Fax:937-274-6834
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH155901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice