Provider Demographics
NPI:1316197585
Name:TALER, DAVID JOACHIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOACHIM
Last Name:TALER
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 1:803 S DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3318
Mailing Address - Country:US
Mailing Address - Phone:443-286-9096
Mailing Address - Fax:
Practice Address - Street 1:3435 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3217
Practice Address - Country:US
Practice Address - Phone:773-588-8200
Practice Address - Fax:773-588-8208
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD390200000X122300000X
IL019028687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist