Provider Demographics
NPI:1265571715
Name:DEMOSS, ANGELA DAWN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DAWN
Last Name:DEMOSS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:232 WILTSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2634
Mailing Address - Country:US
Mailing Address - Phone:937-293-9350
Mailing Address - Fax:
Practice Address - Street 1:120 W WENGER RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2725
Practice Address - Country:US
Practice Address - Phone:937-836-1206
Practice Address - Fax:937-836-3620
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300198181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry