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NPI 1932248713

NPI 1932248713 : DR. JMAES E WEST : THE DALLES, OR

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General NPI Number Information
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    NPI Number           |    1932248713
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    Entity Type          |    Individual 
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    Provider Name        |    DR. JMAES E WEST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/06/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1625 E 12TH ST 
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    City                 |    THE DALLES
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    State                |    OR
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    Zip                  |    97058-3212
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    Country              |    US
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    Telephone            |    541-298-6910
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    Fax                  |    541-298-6912
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Provider Business Mailing Address
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    Address Line         |    1625 E 12TH ST 
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    City                 |    THE DALLES
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    State                |    OR
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    Zip                  |    97058-3212
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    Country              |    US
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    Telephone            |    541-298-6910
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    Fax                  |    541-298-6912
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    D6893
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    License Number State |    OR
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