| David R. Backus DDS, Inc. | |
|
4720 Jackman Rd Suite A Toledo OH 43612-2077 | |
| (419) 476-1484 | |
| (419) 476-6914 |
| Full Name | David R. Backus DDS, Inc. |
|---|---|
| Speciality | Dentist - Dental Anesthesiology |
| Location | 4720 Jackman Rd, Toledo, Ohio |
| Authorized Official Name and Position | Amy J Backus (TREASURER) |
| Authorized Official Contact | 4194761484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David R. Backus DDS, Inc. 4720 Jackman Rd Suite A Toledo OH 43612-2077 Ph: (419) 476-1484 | David R. Backus DDS, Inc. 4720 Jackman Rd Suite A Toledo OH 43612-2077 Ph: (419) 476-1484 |
| NPI Number | 1245691492 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 03/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245691492 | NPI | - | NPPES |
| 0934181 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dental Anesthesiology | 18187 (Ohio) | Primary |
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