42 North Dental Care of Indiana, LLC

NPI #1477254399 in Elkhart, Indiana

Provider Information

NPI Number
1477254399
Entity Type
Organization
Organization Name
42 North Dental Care of Indiana, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
-
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Mar 16, 2023
Last Updated
Mar 16, 2023

Practice Location

Address
1520 OSOLO RD
State
Indiana
ZIP Code
46514-4122
Phone
(574) 262-9619

Authorized Official

Name
MICHAEL ANGELO SCIALABBA
Title
CHIEF DENTAL OFFICER
Phone
(561) 512-2709

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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