Provider Demographics
NPI:1497191019
Name:BOOKWALTER, JAMES ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERIC
Last Name:BOOKWALTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 HUNTER AVE
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3423
Mailing Address - Country:US
Mailing Address - Phone:614-327-8856
Mailing Address - Fax:
Practice Address - Street 1:18 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:OH
Practice Address - Zip Code:43044-1111
Practice Address - Country:US
Practice Address - Phone:937-834-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0239581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice