Dental Consults of Northeast Indiana, PC
NPI #1568580470 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1568580470
- Entity Type
- Organization
- Organization Name
- Dental Consults of Northeast Indiana, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 27, 2007
- Last Updated
- Jun 18, 2008
Practice Location
- Address
- 11115 LIMA RD
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46818-9536
- Phone
- (260) 489-6544
Authorized Official
- Name
- DR. MATTHEW DAVID HALLER, D.M.D.
- Title
- PRESIDENT
- Phone
- (260) 489-6544
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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