Roger Lewis Albrecht
Individual provider Active NPI Dentist · Marysville, OH
NPI 1376646158 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376646158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 14728 (OH)
- Practice address
- 110 Morey Dr
Marysville, OH 43040 - Phone
- (937) 644-1311
- Fax
- (937) 578-2690
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| DN008316 | GA | MD | Dentist |
| 14728 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14728 | OH | Yes |
| Dentist | 122300000X | DN008316 | GA |
Addresses
Primary practice location
110 Morey Dr
Marysville, OH 43040
Mailing address
110 Morey Dr
Marysville, OH 43040
Phone (937) 644-1311
Other providers in Marysville, OH
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.