NPI 1720092521 · live from the CMS NPI Registry
Jon J Eckhardt, DDS, MSD, ABO
Dentist, Orthodontics and Dentofacial Orthopedics in Bryan, OH. National Provider Identifier 1720092521, active.
NPI record
| NPI | 1720092521 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 201 Van Gundy Dr, Ste. C, Bryan, OH 43506 |
| Practice phone | 419-636-5918 |
| Mailing address | 201 Van Gundy Dr Ste C, Bryan, OH 43506 |
| Enumerated | July 28, 2006 |
| Last updated | July 9, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 21018 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.