Premier Dental Group PC

NPI #1497862825 in Merrillville, Indiana

Provider Information

NPI Number: 1497862825
Entity Type: Organization
Organization Name: Premier Dental Group PC
Primary Specialty: Dentist
Enumeration Date: Aug 23, 2006
Last Updated: Sep 22, 2008

Practice Location

Address: 7891 BROADWAY
Address 2: STE C
City: Merrillville
State: Indiana
ZIP Code: 46410
Phone: (219) 736-2273

Authorized Official

Name: DR. STEVEN D COPPES, DDS
Title: PRESIDENT
Phone: (219) 736-2273

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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