Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | RES.3070 | OH |
NPI | 1033405816 |
---|---|
Provider Name | Dr. Jonathan W. Draney |
First Address | Hilliard, OH 43026-9572 |
Second Address | Lancaster, OH 43130-2595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 14/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0081621 | (05) | OH |