Lagrange Family Dentistry LLC

NPI #1710757471 in Lagrange, Indiana

Provider Information

NPI Number: 1710757471
Entity Type: Organization
Organization Name: Lagrange Family Dentistry LLC
Subpart: Yes (part of a larger organization)
Parent Organization: BONTRAGER FAMILY DENTISTRY LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 4, 2024
Last Updated: Jan 4, 2024

Practice Location

Address: 612 S DETROIT ST
City: Lagrange
State: Indiana
ZIP Code: 46761-2314
Phone: (260) 463-2111

Authorized Official

Name: DR. KALYSSA BONTRAGER
Title: OWNER/ DOCTOR
Phone: (260) 463-2111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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