Organization
FAMILY ORTHODONTICS OF OHIO JIM SHEALY DDS LLC
Active
Organization
FAMILY ORTHODONTICS OF OHIO JIM SHEALY DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMONIA LEONARD (CREDENTIALING SPECIALIST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
4440 LINDEN AVE, DAYTON, OH 45432-3031
(937) 252-8651
Mailing address
1350 SPRING ST NW STE 600, ATLANTA, GA 30309-2870
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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