Provider Demographics
NPI:1750461133
Name:DAN H. CONSTABLE, D.D.S. & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DAN H. CONSTABLE, D.D.S. & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CONSTABLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-771-9190
Mailing Address - Street 1:11440 LIPPELMAN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4098
Mailing Address - Country:US
Mailing Address - Phone:513-771-9190
Mailing Address - Fax:513-771-6208
Practice Address - Street 1:11440 LIPPELMAN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4098
Practice Address - Country:US
Practice Address - Phone:513-771-9190
Practice Address - Fax:513-771-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH154111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty