Mabra, Darryl Leo

Mabra, Darryl Leo is an individual health care provider with primary practice located at 125 East Ward Street , Springfield OH 45504-2205. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mabra, Darryl Leo can be contacted via phone (937) 324-0095.

Contact Information

Primary practice address
125 East Ward Street Springfield OH 45504-2205
Phone: (937) 324-0095
Fax: (937) 325-4626
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 16529 Ohio

Profile Details

NPI number 1689760662
LBN Legal business name Mabra, Darryl Leo
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689760662 NPPES
Ohio MEDICAID 0749604
Ohio Other 29854

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