| Organization Name: | DAVID W JAMESON, DDS, LTD |
| NPI Number: | 1477673440 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID WILLIAM JAMESON (PRESIDENT) |
| Mailing Address: | 525 E Water St Bushnell |
| State: | IL US |
| Postal Code: | 614221764 |
| Phone Number: | 3097722124 |
| Fax Number: | 3097722125 |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |