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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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