Provider Demographics
NPI:1528377298
Name:AHMAN, THOMAS LEE (DDS, MS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:AHMAN
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 1:260 S EASTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-2200
Mailing Address - Country:US
Mailing Address - Phone:419-229-8771
Mailing Address - Fax:419-224-2514
Practice Address - Street 1:260 S EASTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45807-2200
Practice Address - Country:US
Practice Address - Phone:419-229-8771
Practice Address - Fax:419-224-2514
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics