Healthcare Provider Details

I. General information

NPI: 1255396040
Provider Name (Legal Business Name): JAMES R HOVELL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 W INDIANOLA
YOUNGSTOWN OH
44511
US

IV. Provider business mailing address

361 W INDIANOLA
YOUNGSTOWN OH
44511
US

V. Phone/Fax

Practice location:
  • Phone: 330-788-6519
  • Fax: 330-788-0870
Mailing address:
  • Phone: 330-788-6519
  • Fax: 330-788-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12685
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: