Provider Demographics
NPI:1295955201
Name:ALBRIGHT, DAVID A (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:ALBRIGHT
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Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9495 KEILMAN ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-8924
Mailing Address - Country:US
Mailing Address - Phone:219-365-2323
Mailing Address - Fax:219-661-9919
Practice Address - Street 1:9495 KEILMAN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-8924
Practice Address - Country:US
Practice Address - Phone:219-365-2323
Practice Address - Fax:219-661-9919
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN86711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics