Individual
DR. JEFFERY R VANTREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2627 BROADWAY AVE, SIDNEY, OH 45365-1507
(937) 492-6984
(937) 492-3802
Mailing address
2627 BROADWAY AVE, SIDNEY, OH 45365-1507
(937) 492-6984
(937) 492-3802
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18418
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0659372
—
OH
Enumeration date
11/16/2006
Last updated
09/30/2014
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