Provider Demographics
NPI:1295943546
Name:WINTER, ELAINE (DDS)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:WINTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 HIGH POINT CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3569
Mailing Address - Country:US
Mailing Address - Phone:937-320-0338
Mailing Address - Fax:
Practice Address - Street 1:914 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-3612
Practice Address - Country:US
Practice Address - Phone:937-323-0522
Practice Address - Fax:937-323-0791
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist