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NPI Code Detail

MEDICARE: DR. JAY FREDERICK KIEFER D.D.S.

MEDICARE:  DR. JAY FREDERICK KIEFER  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
11223G0001XGeneral Practice Dentistry16148OH

General Provider Information

NPI Number : 1922177393
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY FREDERICK KIEFER D.D.S.
Provider Business Mailing Address
First Line : 340 RIDGE RD
Second Line :
City : NEWTON FALLS
State : OH
Zip : 44444-1265
Country : US
Telephone Number : 330-872-5771
Fax Number : 330-872-1681
Provider Business Practice Location Address
First Line : 340 RIDGE RD
Second Line :
City : NEWTON FALLS
State : OH
Zip : 44444-1265
Country : US
Telephone Number : 330-872-5771
Fax Number : 330-872-1681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JAY FREDERICK KIEFER D.D.S.” Practice Location

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