=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417399049
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES HO, D.M.D., P.A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2013
-----------------------------------------------------
Last Update Date | 07/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 430 WAYMONT CT SUITE 110
-----------------------------------------------------
City | LAKE MARY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32746-6745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-322-1688
-----------------------------------------------------
Fax | 407-322-1684
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 430 WAYMONT CT SUITE 110
-----------------------------------------------------
City | LAKE MARY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32746-6745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-322-1688
-----------------------------------------------------
Fax | 407-322-1684
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAMES HO
-----------------------------------------------------
Credential | D.M.D.
-----------------------------------------------------
Telephone | 407-322-1688
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------