Individual
JACOB STADIEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9380 KENWOOD RD, BLUE ASH, OH 45242-6810
(513) 793-4470
Mailing address
9380 KENWOOD RD, BLUE ASH, OH 45242-6810
(513) 793-4770
(513) 793-4772
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30.025621
OH
Other
Enumeration date
10/09/2015
Last updated
03/25/2019
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