Provider Demographics
NPI:1750482295
Name:CHARLES P DEBBANE DDS INC
Entity Type:Organization
Organization Name:CHARLES P DEBBANE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEBBANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-887-6654
Mailing Address - Street 1:518 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3034
Mailing Address - Country:US
Mailing Address - Phone:513-887-6654
Mailing Address - Fax:513-887-1102
Practice Address - Street 1:518 PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3034
Practice Address - Country:US
Practice Address - Phone:513-887-6654
Practice Address - Fax:513-887-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH195201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty