Provider Demographics
NPI:1245430347
Name:OSBORNE, JAMES R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 OAKCREST AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-1936
Mailing Address - Country:US
Mailing Address - Phone:336-282-2868
Mailing Address - Fax:336-282-8144
Practice Address - Street 1:2511 OAKCREST AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-1936
Practice Address - Country:US
Practice Address - Phone:336-282-2868
Practice Address - Fax:336-282-8144
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist