Fontaine Dental Group

NPI #1558591123 in Saint John, Indiana

Provider Information

NPI Number: 1558591123
Entity Type: Organization
Organization Name: Fontaine Dental Group
Primary Specialty: Dentist
Enumeration Date: Jul 17, 2009
Last Updated: Jul 17, 2009

Practice Location

Address: 9301 WICKER AVE
City: Saint John
State: Indiana
ZIP Code: 46373-9403
Phone: (219) 365-7773

Authorized Official

Name: JENNIFER JOY FONTAINE
Title: DDS
Phone: (219) 365-7773

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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