Provider Demographics
NPI:1528196540
Name:ARNOLD, J. JEFFREY (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:JEFFREY
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6923
Mailing Address - Country:US
Mailing Address - Phone:440-992-8800
Mailing Address - Fax:440-998-6620
Practice Address - Street 1:4430 MAIN AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6923
Practice Address - Country:US
Practice Address - Phone:440-992-8800
Practice Address - Fax:440-998-6620
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300184781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics