Provider Demographics
NPI:1124360441
Name:JONATHAN W. DRANEY, DDS, LLC
Entity Type:Organization
Organization Name:JONATHAN W. DRANEY, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-724-1575
Mailing Address - Street 1:121 E 6TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2595
Mailing Address - Country:US
Mailing Address - Phone:435-724-1575
Mailing Address - Fax:
Practice Address - Street 1:121 E 6TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2595
Practice Address - Country:US
Practice Address - Phone:435-724-1575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty