Provider Demographics
NPI:1770618050
Name:DENTON, MAX LEE I (DC)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:LEE
Last Name:DENTON
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4260
Mailing Address - Country:US
Mailing Address - Phone:740-387-3185
Mailing Address - Fax:740-387-4238
Practice Address - Street 1:520 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4260
Practice Address - Country:US
Practice Address - Phone:740-387-3185
Practice Address - Fax:740-387-4238
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH733111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0433043Medicaid
OHT47062Medicare UPIN
OH0433043Medicaid
OH6227110001Medicare NSC