Organization
JON R. EWIG, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON ROBERT EWIG D.D.S. (PRESIDENT)
(937) 426-8083
Entity
Organization
Contact information
Practice address
3585 WENDLETON LN, BEAVERCREEK, OH 45432-2753
(937) 426-8083
(937) 426-2818
Mailing address
3585 WENDLETON LN, BEAVERCREEK, OH 45432-2753
(937) 426-8083
(937) 426-2818
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19277
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0854928
—
OH
01
—
19277
OHIO LICENSE
OH
Enumeration date
05/26/2006
Last updated
08/22/2020
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