Provider Demographics
NPI:1043384415
Name:BATTERTON, ERIC LOWELL (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LOWELL
Last Name:BATTERTON
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 1:460 W CENTRAL AVE
Mailing Address - Street 2:STE F
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1436
Mailing Address - Country:US
Mailing Address - Phone:740-815-0036
Mailing Address - Fax:740-369-3163
Practice Address - Street 1:494 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1470
Practice Address - Country:US
Practice Address - Phone:740-363-9741
Practice Address - Fax:740-369-3163
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH205011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325286Medicaid