Provider Demographics
NPI:1598837965
Name:HIMLER, JEFFREY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:HIMLER
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 1:1139 N MAPLE ST
Mailing Address - Street 2:P O BOX 703
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9794
Mailing Address - Country:US
Mailing Address - Phone:937-644-1115
Mailing Address - Fax:937-642-0026
Practice Address - Street 1:1139 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9794
Practice Address - Country:US
Practice Address - Phone:937-644-1115
Practice Address - Fax:937-642-0026
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300180991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice