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General NPI Number Information
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NPI Number | 1053535534
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Entity Type | Individual
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Provider Name | JODY WILLIAM AMES D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1195 W 2ND ST
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City | XENIA
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State | OH
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Zip | 45385-3702
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Country | US
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Telephone | 937-372-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 W LOCUST ST SUITE 400
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City | WILMINGTON
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State | OH
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Zip | 45177-2572
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Country | US
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Telephone | 937-382-6971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30020527
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License Number State | OH
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