Trost, David Ralph

Trost, David Ralph is an individual health care provider with primary practice located at 134 Mckinley St , East Peoria IL 61611-2550. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Trost, David Ralph can be contacted via phone (309) 699-6770.

Contact Information

Primary practice address
134 Mckinley St East Peoria IL 61611-2550
Phone: (309) 699-6770
Fax: (309) 699-6771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019-016607 Illinois

Profile Details

NPI number 1033263173
LBN Legal business name Trost, David Ralph
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033263173 NPPES
Illinois MEDICAID 019-016607

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