Lifetime Dental Careof Indiana, PC

NPI #1891917282 in South Bend, Indiana

Provider Information

NPI Number: 1891917282
Entity Type: Organization
Organization Name: Lifetime Dental Careof Indiana, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 3, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1605 NORTH IRONWOOD
City: South Bend
State: Indiana
ZIP Code: 46635
Phone: (574) 271-9693

Authorized Official

Name: AMY KROEGER
Title: INS COOD
Phone: (217) 540-5100

Specialties & Taxonomy Codes

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

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