Provider Demographics
NPI:1619237088
Name:OSER, DAVID GILBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GILBERT
Last Name:OSER
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 1:901 W MADISON ST UNIT 619
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3372
Mailing Address - Country:US
Mailing Address - Phone:608-886-7924
Mailing Address - Fax:
Practice Address - Street 1:901 W MADISON ST UNIT 619
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3372
Practice Address - Country:US
Practice Address - Phone:608-886-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-20
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562061223G0001X
IL0190311091223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice