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General NPI Number Information
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NPI Number | 1982317269
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Entity Type | Organization
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Legal Business Name | JBOOKWALTER LLC
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 73 SPORTSMAN DR STE A
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City | MARENGO
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State | OH
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Zip | 43334-1800
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Country | US
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Telephone | 419-253-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 98 ERIE RD
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City | COLUMBUS
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State | OH
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Zip | 43214-3613
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | JAMES BOOKWALTER
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Credential | DDS
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Telephone | 614-327-8856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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