Provider Demographics
NPI:1922143502
Name:ACHBERGER, ROMAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:
Last Name:ACHBERGER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 OZEM GARDNER WAY
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5099
Mailing Address - Country:US
Mailing Address - Phone:614-841-0819
Mailing Address - Fax:
Practice Address - Street 1:722 S SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2630
Practice Address - Country:US
Practice Address - Phone:419-562-9900
Practice Address - Fax:419-562-4002
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0223021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics