Provider Demographics
NPI:1124023676
Name:DASH, JAMES M (DD,S)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:DASH
Suffix:
Gender:M
Credentials:DD,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-1090
Mailing Address - Country:US
Mailing Address - Phone:423-442-3928
Mailing Address - Fax:423-442-9148
Practice Address - Street 1:210 WARREN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-1090
Practice Address - Country:US
Practice Address - Phone:423-442-3928
Practice Address - Fax:423-442-9148
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS-37981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice