Provider Demographics
NPI:1730536053
Name:LEVINE, DAVID NATHAN (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:NATHAN
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 WEST PRATT SREET
Mailing Address - Street 2:APARTMENT 1007
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:724-809-7667
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN-STANTON RD,
Practice Address - Street 2:CHRISTIANA HEALTH CARE
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718
Practice Address - Country:US
Practice Address - Phone:302-733-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program