Provider Demographics
NPI:1528027877
Name:WITT, DENNIS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:WITT
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 1:27345 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:W HARRISON
Mailing Address - State:IN
Mailing Address - Zip Code:47060-9671
Mailing Address - Country:US
Mailing Address - Phone:812-637-5647
Mailing Address - Fax:812-637-5647
Practice Address - Street 1:27345 N STATE ST
Practice Address - Street 2:
Practice Address - City:W HARRISON
Practice Address - State:IN
Practice Address - Zip Code:47060-9671
Practice Address - Country:US
Practice Address - Phone:812-637-5647
Practice Address - Fax:812-637-5647
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007539A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0447270Medicaid