Provider Demographics
NPI:1699900761
Name:ASHVILLE DENTAL, JEFFREY L ANGART, DDS, INC
Entity type:Organization
Organization Name:ASHVILLE DENTAL, JEFFREY L ANGART, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANGART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-983-3151
Mailing Address - Street 1:22 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43103-1273
Mailing Address - Country:US
Mailing Address - Phone:740-983-3151
Mailing Address - Fax:866-682-5140
Practice Address - Street 1:22 MILLER AVE
Practice Address - Street 2:
Practice Address - City:ASHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43103-1273
Practice Address - Country:US
Practice Address - Phone:740-983-3151
Practice Address - Fax:866-682-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH176271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty