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Dr. Gina Michele Domm, DDS
Military Health Care Provider in Dayton, Ohio
NPI 1346530144

Gina Michele Domm is a Military Health Care Provider based in Dayton, OH. Gina Michele Domm practices in Dayton, OH and has the professional credentials of DDS. The NPI Number for Gina Michele Domm is 1346530144 and holds a License No. (Ohio).

The current practice location address for Gina Michele Domm is 4881 Sugar Maple Dr, Dayton, OH and can be reached out via phone at 803-895-6356.

Location: 4881 Sugar Maple Dr, Dayton, OH, 45433-5529
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346530144
Provider Name
Gina Michele Domm
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
4881 Sugar Maple Dr, Dayton, OH, 45433-5529
Phone Number
803-895-6356
Fax Number
Provider Enumeration Date
04/13/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4881 Sugar Maple Dr
City
Dayton
State
Ohio
Zip
45433-5529
Phone Number
803-895-6356
Fax Number
person
Provider Business Mailing Address Details
Address
4881 Sugar Maple Dr
City
Dayton
State
Ohio
Zip
45433-5529
Phone Number
803-895-6356
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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