Provider Demographics
NPI:1962598037
Name:JAMES, BRIAN L (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:L
Last Name:JAMES
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 1:630 S MAIN ST
Mailing Address - Street 2:PO BOX 416
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1709
Mailing Address - Country:US
Mailing Address - Phone:319-465-3533
Mailing Address - Fax:319-465-4947
Practice Address - Street 1:630 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1709
Practice Address - Country:US
Practice Address - Phone:319-465-3533
Practice Address - Fax:319-465-4947
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA072301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice