MEDICARE: DR. JAMES THOMAS EIMER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	30-019262	OH

General Provider Information

NPI Number	:	1437373537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES THOMAS EIMER D.D.S.

Provider Business Mailing Address
First Line	:	1021 SCHNEIDER ST SE
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-3857
Country	:	US
Telephone Number	:	330-494-4310
Fax Number	:	330-494-3572

Provider Business Practice Location Address
First Line	:	1021 SCHNEIDER ST SE
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-3857
Country	:	US
Telephone Number	:	330-494-4310
Fax Number	:	330-494-3572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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