Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 0401004486 | VA |
NPI | 1053375667 |
---|---|
Provider Name | Dr. David E. Bittel |
First Address | Roanoke, VA 24018-4004 |
Second Address | Roanoke, VA 24018-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 08/07/2007 |