Cicero Family Dental LLC

NPI #1912424672 in Cicero, Indiana

Provider Information

NPI Number: 1912424672
Entity Type: Organization
Organization Name: Cicero Family Dental LLC
Primary Specialty: Dentist
Enumeration Date: Aug 24, 2017
Last Updated: Jul 31, 2024

Practice Location

Address: 411 N PERU ST
City: Cicero
State: Indiana
ZIP Code: 46034-9498
Phone: (317) 984-3531

Authorized Official

Name: BLAKE WESTRA, DMD
Title: OWNER
Phone: (217) 549-6928

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X
Dentist	122300000X	Primary

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