Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 17031 | OH |
NPI | 1003907270 |
---|---|
Provider Name | Joe F Inman |
First Address | Sylvania, OH 43560 |
Second Address | Sylvania, OH 43560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |