Peter John Disalvo, DDS
Individual provider Active NPI Dentist · Versailles, OH
NPI 1366566804 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366566804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30 01307 (OH)
- Practice address
- 9977 State Route 185
Versailles, OH 45380-9568 - Phone
- (937) 526-3454
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30 01307 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30 01307 | OH | Yes |
Addresses
Primary practice location
9977 State Route 185
Versailles, OH 45380-9568
Mailing address
10484 Kley Rd
Versailles, OH 45380-9561
Phone (937) 526-5858
Other providers in Versailles, OH
- Janelle Nicole Brunswick
- Cain Chiropractic & Family Wellness LLC
- Amanda Campbell
- Tracy Lynne Cordonnier
- Covenant Care Ohio, Inc.
- Daniel J Elshoff
- Family Health Services of Darke County, Inc.
- Family Health Services of Darke County, Inc.
- Family Health Services of Darke County, Inc.
- Kenneth G. Harshbarger
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.