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Individual

DANA JEAN OATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
315 N DETROIT ST, KENTON, OH 43326-1575
(419) 673-5201
(419) 673-8652
Mailing address
315 N DETROIT ST, KENTON, OH 43326-1575
(419) 673-5201
(419) 673-8652

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4451
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2241578
OH
01
341214040029
CARESOURCE
OH
Enumeration date
09/29/2006
Last updated
06/19/2008
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