Bdd of Indiana P.c.
NPI #1366117889 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1366117889
- Entity Type
- Organization
- Organization Name
- Bdd of Indiana P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BDD OF INDIANA P.C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 16, 2021
- Last Updated
- Jul 26, 2024
Practice Location
- Address
- 10435 ILLINOIS RD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46814-9181
- Phone
- (260) 469-3671
Authorized Official
- Name
- STEPHANIE MOORE
- Title
- DIRECTOR OF REVENUE CYCLE
- Phone
- (832) 704-4262
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - General Practice — General Practice |
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