Provider Demographics
NPI:1144207994
Name:WARE, JAMES JOSEPH SR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:WARE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 EAST VICTORY DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404
Mailing Address - Country:US
Mailing Address - Phone:912-443-6013
Mailing Address - Fax:912-443-6014
Practice Address - Street 1:2127 EAST VICTORY DRIVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-443-6013
Practice Address - Fax:912-443-6014
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0096671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice