Provider Demographics
NPI:1952771081
Name:JAMES L SALTZGIVER JR DDS INC
Entity Type:Organization
Organization Name:JAMES L SALTZGIVER JR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALTZGIVER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-756-1379
Mailing Address - Street 1:370 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1057
Mailing Address - Country:US
Mailing Address - Phone:419-756-1379
Mailing Address - Fax:419-756-2614
Practice Address - Street 1:370 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1057
Practice Address - Country:US
Practice Address - Phone:419-756-1379
Practice Address - Fax:419-756-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30032853122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty