Lifetime Dental Care of Indiana, PC
NPI #1336361740 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1336361740
- Entity Type
- Organization
- Organization Name
- Lifetime Dental Care of Indiana, PC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LIFETIME DENTAL CARE OF INDIANA, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 3, 2007
- Last Updated
- Nov 1, 2014
Practice Location
- Address
- 2828 E STATE BLVD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46805-4761
- Phone
- (260) 482-6689
Authorized Official
- Name
- JENNIFER HOELSCHER
- Title
- INS COOD
- Phone
- (217) 540-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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