Prime Dental Care LLC
NPI #1053199539 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1053199539
- Entity Type
- Organization
- Organization Name
- Prime Dental Care LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 18, 2023
- Last Updated
- Sep 18, 2023
Practice Location
- Address
- 435 W COLISEUM BLVD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46805-1010
- Phone
- (260) 263-6200
Authorized Official
- Name
- DR. VIJAY KUMAR GODI, DDS
- Title
- DENTIST
- Phone
- (419) 788-5803
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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