| 42 North Dental Care Of Indiana, Llc | |
|
1520 Osolo Rd Elkhart IN 46514-4122 | |
| (574) 262-9619 | |
| Not Available |
| Full Name | 42 North Dental Care Of Indiana, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1520 Osolo Rd, Elkhart, Indiana |
| Authorized Official Name and Position | Michael Angelo Scialabba (CHIEF DENTAL OFFICER) |
| Authorized Official Contact | 5615122709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 42 North Dental Care Of Indiana, Llc 200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: () - | 42 North Dental Care Of Indiana, Llc 1520 Osolo Rd Elkhart IN 46514-4122 Ph: (574) 262-9619 |
| NPI Number | 1477254399 |
|---|---|
| Provider Enumeration Date | 03/16/2023 |
| Last Update Date | 03/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477254399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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