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General NPI Number Information
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NPI Number | 1902141351
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Entity Type | Organization
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Legal Business Name | JAMES T. MCKOWN D.D.S., INC.
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 938 WEST MAIN ST SUITE 4
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City | HILLSBORO
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State | OH
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Zip | 45133-7656
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Country | US
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Telephone | 937-393-9913
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Fax | 937-393-3795
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Provider Business Mailing Address
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Address Line | 938 WEST MAIN ST SUITE 4
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City | HILLSBORO
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State | OH
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Zip | 45133-7656
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Country | US
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Telephone | 937-393-9913
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Fax | 937-393-3795
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | JAMES THOMAS MCKOWN
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Credential | D.D.S.
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Telephone | 937-393-9913
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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 | 14698
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License Number State | OH
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