MEDICARE: DR. JEFFREY L. ANGART DMD

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	1223G0001X	General Practice Dentistry	17627	OH

General Provider Information

NPI Number	:	1699724377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY L. ANGART DMD

Provider Business Mailing Address
First Line	:	240B MARKET ST
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9791
Country	:	US
Telephone Number	:	614-775-0840
Fax Number	:

Provider Business Practice Location Address
First Line	:	240B MARKET ST
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9791
Country	:	US
Telephone Number	:	614-775-0840
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/08/2007

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