Provider Demographics
NPI:1841318458
Name:JAMES H. ARNOLD AND ASSOCIATES
Entity type:Organization
Organization Name:JAMES H. ARNOLD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-926-5445
Mailing Address - Street 1:1830 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9381
Mailing Address - Country:US
Mailing Address - Phone:219-926-5445
Mailing Address - Fax:219-921-1234
Practice Address - Street 1:1830 S 11TH ST
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9381
Practice Address - Country:US
Practice Address - Phone:219-926-5445
Practice Address - Fax:219-921-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120098421223G0001X
IN12010569A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty