Provider Demographics
NPI:1750584678
Name:JEFFREY E. HIMLER, DDS, INC
Entity type:Organization
Organization Name:JEFFREY E. HIMLER, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIMLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-644-1115
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:1139 N. MAPLE ST
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300180991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty