Organization
SHAWNEE STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROGER KADEL D.D.S. (SUPERVISING DENTIST - SHAWNEE STATE)
(740) 351-3216
Entity
Organization
Contact information
Practice address
940 SECOND ST., HEALTH SCIENCES DEPT., PORTSMOUTH, OH 45662-4344
(740) 351-3216
(740) 351-3354
Mailing address
940 SECOND ST., HEALTH SCIENCES DEPT., PORTSMOUTH, OH 45662-4344
(740) 351-3216
(740) 351-3354
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30-012492
OH
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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