Individual
DR. EDWARD T JACHYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
406 MARION AVE, MANSFIELD, OH 44903
(419) 526-1234
Mailing address
406 MARION AVE, MANSFIELD, OH 44903
(419) 526-1234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30018878
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102899402699
—
OH
Enumeration date
09/07/2006
Last updated
07/08/2007
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