Provider Demographics
NPI:1326151440
Name:JAMES R MALE DDS INC
Entity Type:Organization
Organization Name:JAMES R MALE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MALE
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-471-3020
Mailing Address - Street 1:55 GRANVILLE ST
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3003
Mailing Address - Country:US
Mailing Address - Phone:614-471-3020
Mailing Address - Fax:614-428-9391
Practice Address - Street 1:55 GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3003
Practice Address - Country:US
Practice Address - Phone:614-471-3020
Practice Address - Fax:614-428-9391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300173791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty