Provider Demographics
NPI:1053375667
Name:BITTEL, DAVID E (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:BITTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4004
Mailing Address - Country:US
Mailing Address - Phone:540-989-3639
Mailing Address - Fax:540-989-4749
Practice Address - Street 1:3650 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4004
Practice Address - Country:US
Practice Address - Phone:540-989-3639
Practice Address - Fax:540-989-4749
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010044861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry