Provider Demographics
NPI:1346335973
Name:BOHMAN, ANTHONY JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAY
Last Name:BOHMAN
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 1:1107 ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-8763
Mailing Address - Country:US
Mailing Address - Phone:513-831-1941
Mailing Address - Fax:513-831-1952
Practice Address - Street 1:1107 ALLEN DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8763
Practice Address - Country:US
Practice Address - Phone:513-831-1941
Practice Address - Fax:513-831-1952
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice